WorldWideScience

Sample records for care crisis mother

  1. US health care crisis.

    Science.gov (United States)

    Cirić, Ivan

    2013-01-01

    The United States health care is presently challenged by a significant economic crisis. The purpose of this report is to introduce the readers of Medicinski Pregled to the root causes of this crisis and to explain the steps undertaken to reform health care in order to solve the crisis. It is hoped that the information contained in this report will be of value, if only in small measure, to the shaping of health care in Serbia.

  2. The mood variation in mothers of preterm infants in Kangaroo mother care and conventional incubator care.

    Science.gov (United States)

    de Macedo, Elizeu Coutinho; Cruvinel, Fernando; Lukasova, Katerina; D'Antino, Maria Eloisa Famá

    2007-10-01

    Preterm babies are more prone to develop disorders and so require immediate intensive care. In the conventional neonatal intensive care, the baby is kept in the incubator, separated from the mother. Some actions have been taken in order to make this mother-child separation less traumatic. One of these actions is the Kangaroo mother care (KMC) characterized by skin-to-skin contact between a mother and her newborn. The objective of this study was to compare the mood variation of mothers enrolled in the KMC program to those in the conventional incubator care. In one general hospital in Sao Paulo, Brazil, 90 mothers were evaluated before and after contact with the baby in the Neonatal Intensive Care Unit. The participants were divided into three groups: 30 mothers of term newborns (TG), 30 mothers of preterm infants included in KMC program (PGK) and 30 preterms with incubator placement (PGI). The Brazilian version of the Visual Analogue Mood Scale (VAMS) was used for the assessment before and after the infant's visit. Results showed that TG mothers reported fewer occurrences of depressive states than PGK and PGI mothers. A significant mood variation was observed for PGK and PGI after the infant's visit. PGK mothers reported feeling calmer, stronger, well-coordinated, energetic, contented, tranquil, quick-witted, relaxed, proficient, happy, friendly and clear-headed. The only variation showed by PGI mothers was an increase in feeling clumsy. This study shows a positive effect of the KMC on the mood variation of preterm mothers and points to the need of a more humane experience during the incubator care.

  3. Practicing discernment: pastoral care in crisis situations.

    Science.gov (United States)

    Landes, Scott D

    2010-01-01

    This article correlates a particular experience of providing pastoral care for a person in a crisis situation with a particular understanding of the practice of pastoral care. Through engaging in correlative practical theology, it highlights the need for practicing discernment when providing pastoral care for persons utilizing narratives to work through crisis situations.

  4. Indonesian heath care and the economic crisis: is managed care the needed reform?

    Science.gov (United States)

    Hotchkiss, D R; Jacobalis, S

    1999-03-01

    The ramifications of the current economic crisis are being felt throughout Asia, but problems are particularly acute in Indonesia; in the midst of high inflation and unemployment the government is considering expanding managed care reform. In this paper, we discuss the impact of the recent economic crisis on the health sector in Indonesia, and analyze the potential for implementing effective reform following the managed care model. The health sector is discussed, highlighting pre-existing problems in the health care supply environment. The determinants of the economic crisis are summarized, and the broad impacts of the crisis to date on the health sector are assessed. Next the prospects for success of current managed-care reform proposals are examined in some detail: viability of expanded managed care reform measures are assessed in light of the continuing crisis and its likely impacts on the consumers and suppliers of health care. Analysis of the potential impact of the continuing crisis focuses on key participants in health care reform: households, the government, and private health care providers. In conclusion the potential viability of managed care appears poor, given the current economic, political, and institutional conditions and likely future impacts, and suggest some alternative reform measures.

  5. Reviewing the definition of crisis in dementia care

    NARCIS (Netherlands)

    MacNeil-Vroomen, J.L.; Bosmans, J.E.; van Hout, H.P.J.; de Rooij, S.E.

    2013-01-01

    Background: Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice.

  6. Reviewing the definition of crisis in dementia care

    NARCIS (Netherlands)

    Vroomen, Janet MacNeil; Bosmans, Judith E.; van Hout, Hein P. J.; de Rooij, Sophia E.

    2013-01-01

    Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. We systematically

  7. Care demands on mothers caring for a child with Down syndrome: Malaysian (Sarawak) mothers' perspectives.

    Science.gov (United States)

    Chan, Kim Geok; Lim, Khatijah Abdullah; Ling, How Kee

    2015-10-01

    This paper examines the experiences of mothers caring for a child with Down syndrome in the Malaysian (Sarawak) context. Qualitative interviews were conducted with 26 biological mothers of children with Down syndrome aged 18 years and below. They were accessed through selected child health clinics, community-based rehabilitation centres and schools using purposive sampling within two regions in Sarawak, one of the two Borneo States of Malaysia. Major themes emerging within the context of care demands were children's health, developmental delays, daily needs and behaviour issues. The insights obtained into the care demands experienced by mothers of children with Down syndrome have several implications for practice by care professionals. © 2014 Wiley Publishing Asia Pty Ltd.

  8. Privatisation & marketisation of post-birth care: the hidden costs for new mothers

    Directory of Open Access Journals (Sweden)

    Benoit Cecilia

    2012-10-01

    Full Text Available Abstract Retrenchment of government services has occurred across a wide range of sectors and regions. Care services, in particular, have been clawed away in the wake of fiscal policies of cost containment and neoliberal policies centred on individual responsibility and market autonomy. Such policies have included the deinstitutionalisation of care from hospitals and clinics, and early discharge from hospital, both of which are predicated on the notion that care can be provided informally within families and communities. In this paper we examine the post-birth "care crisis" that new mothers face in one region of Canada. Method The data are drawn from a larger study of social determinants of pregnant and new mothers' health in Victoria, Canada. Mixed methods interviews were conducted among a purposive sample of women at three points in time. This paper reports data on sample characteristics, length of stay in hospital and health service gaps. This data is contextualised via a more in-depth analysis of qualitative responses from Wave 2 (4-6 weeks postpartum. Results Out results show a significant portion of participants desired services that were not publically available to them during the post-birth period. Among those who reported a gap in care, the two most common barriers were: cost and unavailability of home care supports. Participants' open-ended responses revealed many positive features of the public health care system but also gaps in services, and economic barriers to receiving the care they wanted. The implications of these findings are discussed in relation to recent neoliberal reforms. Discussion & conclusions While Canada may be praised for its public provision of maternity care, mothers' reports of gaps in care during the early postpartum period and increasing use of private doulas is a worrying trend. To the extent that individual mothers or families rely on the market for care provision, issues of equity and quality of care are

  9. [Care of mothers of newborns in intensive care units: experiences, feelings and expectations of the mothers].

    Science.gov (United States)

    Belli, M A

    1995-08-01

    The purpose of the study was to examine the experiences, feelings and expectation of mothers of high risk newborns. The population was a group of 20 mothers of high risk newborns of three hospitals in the City of São Paulo. Interview with the mothers was the method of data collection containing opened and structured questions. It was verified that most of the mothers had none or only a little interaction with the newborn after delivery; the eye contact was the most referred during the staying of the newborn in the Intensive Care Unity; all of them demonstrated interest in participating in the care of the newborn and expressed the need of information concerning to the health status of the newborn, the Intensive Care Unity environment and the hospital team. Several were the feelings expressed and the motives that indicated the needs of the mothers.

  10. Utilization of medical care following the Three Mile Island crisis

    International Nuclear Information System (INIS)

    Houts, P.S.; Hu, T.W.; Henderson, R.A.; Cleary, P.D.; Tokuhata, G.

    1984-01-01

    Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small

  11. Utilization of medical care following the Three Mile Island crisis.

    Science.gov (United States)

    Houts, P S; Hu, T W; Henderson, R A; Cleary, P D; Tokuhata, G

    1984-02-01

    Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small.

  12. A Cost Sharing Plan: Solutions for the Child Care Crisis.

    Science.gov (United States)

    Delaware Valley Child Care Council, Philadelphia, PA.

    This booklet discusses the current child care crisis and suggests a solution to the crisis. The gap between the cost of child care and parents' ability to pay is restricting the expansion and availability of child care services and undercutting the quality of child care. The average cost of full-day child care in the Delaware Valley, Pennsylvania,…

  13. Intercultural caring from the perspectives of immigrant new mothers.

    Science.gov (United States)

    Wikberg, Anita; Eriksson, Katie; Bondas, Terese

    2012-01-01

    To describe and interpret the perceptions and experiences of caring of immigrant new mothers from an intercultural perspective in maternity care in Finland. Descriptive interpretive ethnography using Eriksson's theory of caritative caring. A maternity ward in a medium-sized hospital in western Finland. Seventeen mothers from 12 countries took part in the study. Interviews, observations, and field notes were analyzed and interpreted. Most mothers were satisfied with the equal access to high-quality maternity care in Finland, although the stereotypes and the ethnocentric views of some nurses negatively influenced the experiences of maternity care for some mothers. The cultural background of the mother, as well as the Finnish maternity care culture, influenced the caring. Four patterns were found. There were differences between the expectations of the mothers and their Finnish maternity care experience of caring. Caring was related to the changing culture. Finnish maternity care traditions were sometimes imposed on the immigrant new mothers, which likewise influenced caring. However, the female nurse was seen as a professional friend, and the conflicts encountered were resolved, which in turn promoted caring. The influence of Finnish maternity care culture on caring is highlighted from the perspective of the mothers. Intercultural caring was described as universal, cultural, contextual, and unique. Women were not familiar with the Finnish health care system, and many immigrant mothers lacked support networks. The nurse/patient relationship could partly replace their support if the relationship was perceived as caring. The women had multiple vulnerabilities and were prone to isolation and discrimination if they experienced communication problems. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  14. Does care matter? Care capital and mothers' time to paid employment.

    Science.gov (United States)

    Loft, Lisbeth Trille G; Hogan, Dennis

    2014-09-01

    The aim of this study is to introduce the concept of care capital and provide an example of its application in the context of childcare and maternal employment using the currently most suitable American data. We define care capital as the nexus of available, accessible, and experienced resources for care. The American setting is an ideal context to investigate the linkages between child care capital and maternal employment as the patterns of child care use tend to be more diverse compared to other national contexts. In the presented application of care capital, we examine mothers' entry to paid employment during the first 36 weeks following a birth, and its association with the experience of non-parental child care use before labour force entry. Using data from the Early Childhood Longitudinal Survey-Birth Cohort ( N = 10,400 mothers), results from discrete-time hazard models show that use of non-parental child care prior to employment is independently and positively associated with entry into maternal employment. This finding applies both to first-time mothers ( n = 3,800) and to mothers of multiple children ( n = 6,600). Although data currently available for investigating child care capital are limited with regard to care availability and access, our results suggests that childcare availability, access, and use, understood as a form of capital alongside economic and human capital, should be considered in future studies of maternal employment.

  15. The nursing process in crisis-oriented psychiatric home care.

    Science.gov (United States)

    Boomsma, J; Dingemans, C A; Dassen, T W

    1997-08-01

    Crisis-oriented psychiatric home care is a recent development in the Dutch mental health care system. Because of the difference between psychiatric care in the home and in the hospital, an action research project was initiated. This project was directed at the nursing process and the nurses' role and skills in psychiatric home care. The main goal of the project was to describe and to standardize nursing diagnoses and interventions used in crisis-oriented and long-term psychiatric home care. The development of supporting methods of assessment and intervention were also important aspects of this project. In this article a crisis-oriented psychiatric home care programme and the first developmental research activities within this programme are described. To support the nursing process, the development of a nursing record and an assessment-format, based on Gordon's Functional Health Patterns (FHP), took place. By means of content analysis of 61 nursing records, the most frequently stated nursing diagnoses, based upon the North American Nursing Diagnosis Association (NANDA) taxonomy, were identified. The psychiatric diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) were also collected. The most common categories found were those of mood disorders and schizophrenia or psychotic disorders. Seventy-five per cent of the nursing diagnoses showed up within four FHP: role-relationship, coping-stress tolerance, self-perception/self-concept and activity-exercise. The nursing diagnosis of 'ineffective individual coping' was stated most frequently. This is not surprising because of the similarities in the definitions of this nursing diagnosis and the concept of 'crisis' to which the psychiatric home care programme is oriented. Further research activities will be focused on standardization of nursing diagnosis and the interventions that nurses undertake in this type of care.

  16. Increasing Confidence and Ability in Implementing Kangaroo Mother Care Method Among Young Mothers.

    Science.gov (United States)

    Kenanga Purbasary, Eleni; Rustina, Yeni; Budiarti, Tri

    Mothers giving birth to low birth weight babies (LBWBs) have low confidence in caring for their babies because they are often still young and may lack the knowledge, experience, and ability to care for the baby. This research aims to determine the effect of education about kangaroo mother care (KMC) on the confidence and ability of young mothers to implement KMC. The research methodology used was a controlled-random experimental approach with pre- and post-test equivalent groups of 13 mothers and their LBWBs in the intervention group and 13 mothers and their LBWBs in the control group. Data were collected via an instrument measuring young mothers' confidence, the validity and reliability of which have been tested with a resulting r value of .941, and an observation sheet on KMC implementation. After conducting the education, the confidence score of young mothers and their ability to perform KMC increased meaningfully. The score of confidence of young mothers before education was 37 (p = .1555: and the ability score for KMC Implementation before education was 9 (p = .1555). The median score of confidence of young mothers after education in the intervention group was 87 and in the control group was 50 (p = .001, 95% CI 60.36-75.56), and ability median score for KMC implementation after education in the intervention group was 16 and in the control group was 12 (p = .001, 95% CI 1.50-1.88). KMC education should be conducted gradually, and it is necessary to involve the family, in order for KMC implementation to continue at home. A family visit can be done for LBWBs to evaluate the ability of the young mothers to implement KMC.

  17. Kangaroo mother care: a systematic review of barriers and enablers.

    Science.gov (United States)

    Chan, Grace J; Labar, Amy S; Wall, Stephen; Atun, Rifat

    2016-02-01

    To investigate factors influencing the adoption of kangaroo mother care in different contexts. We searched PubMed, Embase, Scopus, Web of Science and the World Health Organization's regional databases, for studies on "kangaroo mother care" or "kangaroo care" or "skin-to-skin care" from 1 January 1960 to 19 August 2015, without language restrictions. We included programmatic reports and hand-searched references of published reviews and articles. Two independent reviewers screened articles and extracted data on carers, health system characteristics and contextual factors. We developed a conceptual model to analyse the integration of kangaroo mother care in health systems. We screened 2875 studies and included 112 studies that contained qualitative data on implementation. Kangaroo mother care was applied in different ways in different contexts. The studies show that there are several barriers to implementing kangaroo mother care, including the need for time, social support, medical care and family acceptance. Barriers within health systems included organization, financing and service delivery. In the broad context, cultural norms influenced perceptions and the success of adoption. Kangaroo mother care is a complex intervention that is behaviour driven and includes multiple elements. Success of implementation requires high user engagement and stakeholder involvement. Future research includes designing and testing models of specific interventions to improve uptake.

  18. The Effect of Kangaroo Mother Care Immediately after Delivery on Mother-infant Attachment 3 Months after Delivery

    Directory of Open Access Journals (Sweden)

    Fatemeh Zahra Karimi

    2016-09-01

    Full Text Available Background  The aim of this study was determine the effect of kangaroo mother care (KMC immediately after delivery on mother-infant attachment 3-month after delivery. Materials and Methods: In this RCT study, 72 mother-infant pairs were randomly divided in to kangaroo mother care and routine care groups.The intervention group received kangaroo mother care (KMC in the first two hours post birth. The control group just received routine hospital care. Mothers in the intervention group were encouraged to keep the baby in KMC as much as possible during the day and night throughout the neonatal period. Participants were followed up for three months after birth. The Main outcome measure was mother-infant attachment at 3 months postpartum and maternal anxiety about the baby at the same time. The data was collected by questionnaire (demographic information of parents and neonates and maternal attachment scale. Analysis was performed using SPSS software (version 14. Results: There was no significant difference between two groups regarding their baseline data. Mean maternal attachment score in the KMC group and in the routine care group at three months after delivery was 52.40±3.30 and 49.86±4.18 respectively, which was significantly higher in the KMC group (P

  19. Who Cares for the Children? Denmark's Unique Public Child-Care Model.

    Science.gov (United States)

    Polakow, Valerie

    1997-01-01

    U.S. working mothers wrestle daily with a child-care crisis characterized by unavailable infant care, high costs, and inadequate access and regulation. In Denmark, high-quality child care is a guaranteed entitlement for every child. Other benefits include paid parental leaves, single-parent allowances, housing subsidies, and universal health care.…

  20. [Risk factors associated with mother negligence in child care].

    Science.gov (United States)

    Vargas-Porras, Carolina; Villamizar-Carvajal, Beatriz; Ardila-Suárez, Edinson Fabian

    2016-01-01

    To determine the factors associated with the risk of negligence in child care during the first year of rearing in adolescent and adult mothers. This was cross-sectional correlation study with a non-probabilistic sample composed of 250 mothers during their first year of child rearing. The information was collected through the Parenting Inventory for Teenagers and Adults. 88 teenager mothers and 162 adult mothers participated in this study. In general low scores were found in all dimensions in both adolescent mothers group and adult mother group, which indicate the existence of deficiencies in the adequate maternal behavior and risk of negligent care to their children. In the group of teenage mothers there was an evident and significant correlation between the factors: maternal age and occupation dimension belief in punishment and occupation with inappropriate expectations dimension. The group of adult mothers showed significant correlation between: educational level with the dimensions of role reversal, belief in punishment and lack of empathy; socioeconomic dimension with the belief in punishment and age of the child with the lack of empathy dimension. Child rearing expectations of mothers show a high risk of negligence in child care. Therefore, nurses should promote the strengthening of the maternal role. Copyright © 2016. Published by Elsevier España, S.L.U.

  1. Flood, disaster, and turmoil: social issues in cleft and craniofacial care and crisis relief.

    Science.gov (United States)

    Strauss, Ronald P; van Aalst, John A; Fox, Lynn; Stein, Margot; Moses, Michael; Cassell, Cynthia H

    2011-11-01

    To examine social issues in the conduct of cleft and craniofacial care through relief programs in disrupted crisis contexts. Social, health policy, and ethical analyses. At best, craniofacial team care is multidisciplinary, coordinated, and sustained, requiring a long-term relationship between team members, patients, and families. Disasters and societal turmoil interrupt such relationships, causing craniofacial care to become a secondary concern. Providing craniofacial team care in a crisis setting requires rebuilding disrupted coordination and communication. Crisis relief care involves a complex set of expectations and responsibilities and raises issues such as (1) quality assurance, infection control, appropriate standards of care, and follow-up care/continuity; (2) equity of access to services and clinical ethics in the context of war and/or deprivation; (3) training of visitors in the local nation or site; (4) disciplinary composition of teams, interprofessional communication/rivalry, and credentials of clinicians; (5) ownership of the site and local visitor relations; (6) fundraising and marketing strategies; and (7) ethical issues in the doctor-patient relationship. Specific ethical standards for international cleft and craniofacial care delivery also apply to domestic and global crisis relief contexts. Guidance on issues related to professional experience, informed consent, and continuity of care will help care providers address social and ethical issues raised in crisis relief programs. This paper proposes that the Position Paper of the American Cleft Palate-Craniofacial Association (ACPA) on International Treatment Programs should be used as a template to develop and disseminate a set of standards that apply to crisis relief.

  2. St George Acute Care Team: the local variant of crisis resolution model of care.

    Science.gov (United States)

    Cupina, Denise D; Wand, Anne P F; Phelan, Emma; Atkin, Rona

    2016-10-01

    The objective of this study was to describe functioning and clinical activities of the St George Acute Care Team and how it compares to the typical crisis resolution model of care. Descriptive data including demographics, sources of referral, type of clinical intervention, length of stay, diagnoses and outcomes were collected from records of all patients who were discharged from the team during a 10 week period. There were 677 referrals. The team's functions consisted of post-discharge follow-up (31%), triage and intake (30%), case management support (23%) and acute community based assessment and treatment (16%). The average length of stay was 5 days. The majority of patients were diagnosed with a mood (23%) or a psychotic (25%) disorder. Points of contrast to other reported crisis resolution teams include shorter length of stay, relatively less focus on direct clinical assessment and more telephone follow-up and triage. St George Acute Care Team provides a variety of clinical activities. The focus has shifted away from the original model of crisis resolution care to meet local and governmental requirements. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  3. Mother's time allocation, child care and child cognitive development

    OpenAIRE

    BRILLI, Ylenia

    2015-01-01

    This paper analyzes the effects of maternal employment and non-parental child care on child cognitive development, taking into account the mother's time allocation between leisure and child-care time. I estimate a behavioral model, in which maternal labor supply, non-parental child care, goods expenditure and time allocation decisions are considered to be endogenous choices of the mother. The child cognitive development depends on maternal and non-parental child care and on the goods bought f...

  4. Determinants of cord care practices among mothers in Benin City ...

    African Journals Online (AJOL)

    2011-10-04

    Oct 4, 2011 ... Background: Mothers care for their infants' umbilical cord stump in various ways. Different cord care practices have been documented; some are beneficial while others are harmful. Who and what influence the cord care practiced by mothers have, however, not been fully explored particularly in the study ...

  5. More Than a "Number": Perspectives of Prenatal Care Quality from Mothers of Color and Providers.

    Science.gov (United States)

    Coley, Sheryl L; Zapata, Jasmine Y; Schwei, Rebecca J; Mihalovic, Glen Ellen; Matabele, Maya N; Jacobs, Elizabeth A; Anderson, Cynthie K

    African American mothers and other mothers of historically underserved populations consistently have higher rates of adverse birth outcomes than White mothers. Increasing prenatal care use among these mothers may reduce these disparities. Most prenatal care research focuses on prenatal care adequacy rather than concepts of quality. Even less research examines the dual perspectives of African American mothers and prenatal care providers. In this qualitative study, we compared perceptions of prenatal care quality between African American and mixed race mothers and prenatal care providers. Prenatal care providers (n = 20) and mothers who recently gave birth (n = 19) completed semistructured interviews. Using a thematic analysis approach and Donabedian's conceptual model of health care quality, interviews were analyzed to identify key themes and summarize differences in perspectives between providers and mothers. Mothers and providers valued the tailoring of care based on individual needs and functional patient-provider relationships as key elements of prenatal care quality. Providers acknowledged the need for knowing the social context of patients, but mothers and providers differed in perspectives of "culturally sensitive" prenatal care. Although most mothers had positive prenatal care experiences, mothers also recalled multiple complications with providers' negative assumptions and disregard for mothers' options in care. Exploring strategies to strengthen patient-provider interactions and communication during prenatal care visits remains critical to address for facilitating continuity of care for mothers of color. These findings warrant further investigation of dual patient and provider perspectives of culturally sensitive prenatal care to address the service needs of African American and mixed race mothers. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  6. Mothers' Emotional Care Work in Education and Its Moral Imperative

    Science.gov (United States)

    O'Brien, Maeve

    2007-01-01

    This paper seeks to build on feminist and egalitarian critiques of the traditional allocation of care work to mothers, particularly in relation to understandings of educational care work. It seeks to locate the emotional support work carried out by mothers in the educational field within their daily routines of care, and to make visible the…

  7. Mothers of Pre-Term Infants in Neonate Intensive Care

    Science.gov (United States)

    MacDonald, Margaret

    2007-01-01

    In this study, eight mothers of pre-term infants under the care of nursing staff and neonatologists in the Neonatal Intensive Care Unit (NICU) of Children's Hospital in Vancouver, British Columbia, were observed and interviewed about their birth experience and their images of themselves as mothers during their stay. Patterns and themes in the…

  8. Determinants of cord care practices among mothers in Benin City, Edo State, Nigeria.

    Science.gov (United States)

    Abhulimhen-Iyoha, B I; Ibadin, M O

    2012-01-01

    Mothers care for their infants' umbilical cord stump in various ways. Different cord care practices have been documented; some are beneficial while others are harmful. Who and what influence the cord care practiced by mothers have, however, not been fully explored particularly in the study locale. The objective of this study was to determine the factors that influence cord care practices among mothers in Benin City. The study subjects included 497 mothers who brought their babies to Well Baby/Immunization Clinic at the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, between July and August 2009. A structured questionnaire served as an instrument to extract information on their biodata and possible determinants of cord care practices. Significantly older women (P=0.023), educated mothers (P=0.029), and those who had male babies (P=0.013) practiced beneficial cord stump care practices. Beneficial cord care practice increased with increasing maternal educational status. The best predictors of beneficial cord care practices are maternal level of education (P=0.029) and infant's sex (P=0.013). The use of harmful cord care practices was more common among mothers who delivered outside the Teaching hospitals. Most (71.2%) of the mothers were aware of hygienic/beneficial cord care. The choices of cord care methods eventually practiced by mothers were influenced mainly by the disposition of nurses (51.3%), participants' mothers (32.0%), and their mothers-in-law (5.8%). There was no significant relationship between cord care practice on one hand and maternal parity, tribe, and socioeconomic classes on the other. The need for female education is again emphasized. The current findings strongly justify the need for public enlightenment programs, using the mass media and health talks in health facilities, targeting not only women of reproductive age but also secondary audience like their mothers, mothers-in-law, nurses, and attendants at health facilities

  9. Managing crisis: the role of primary care for people with serious mental illness.

    Science.gov (United States)

    Lester, Helen; Tritter, Jonathan Q; Sorohan, Helen

    2004-01-01

    More than 30% of patients with serious mental illness in the United Kingdom now receive all their health care solely from primary care. This study explored the process of managing acute mental health crises from the dual perspective of patients and primary care health professionals. Eighteen focus groups involving 45 patients, 39 general practitioners, and eight practice nurses were held between May and November 2002 in six Primary Care Trusts across the British West Midlands. The topic guide explored perceptions of gold standard care, current issues and critical incidents in receiving/providing care, and ideas on improving services. Themes relevant to the management of acute crisis included issues of process, such as access, advocacy, communication, continuity, and coordination of care; the development of more structured care that might reduce the need for crisis responses; and issues raised by the development of a more structured approach to care. Access to services is a complicated yet crucial feature of managing care in a crisis, with patients identifying barriers at the level of primary care and health professionals at the interface with secondary care. The development of more structured systems as a solution may generate its own ethical and pragmatic challenges.

  10. General Information about Crisis Nursery Care, ARCH Factsheet Number 1 [and] General Information about Respite Care, ARCH Factsheet Number 2.

    Science.gov (United States)

    North Carolina State Dept. of Human Resources, Raleigh. Div. of Mental Health, Mental Retardation and Substance Abuse Services.

    This document consists of a combination of two separately published fact sheets, one on crisis nursery care for children at risk of abuse or neglect and one on respite care for families of children with disabilities or chronic illness. The fact sheet on crisis nursery care presents background information on the federal role in developing crisis…

  11. Challenges experienced by mothers caring for children with cerebral palsy in Zambia

    Directory of Open Access Journals (Sweden)

    Carol Singogo

    2015-11-01

    Full Text Available Background: Mothers caring for children with disability experience a number of challenges. Aim: The aim of the study was to explore the challenges that mothers who cared for children with cerebral palsy (CP living in Zambia experienced. Methods: During a qualitative study the experiences of 16 conveniently sampled mothers of children with CP, from the Ndola district in Zambia, were explored by means of interviews. The responses were thematically analysed. All the necessary ethical considerations were upheld. Results: Mothers experienced social isolation and marital problems, as well as negative attitudes from family, friends, community members and health care professionals. The physical environment created access challenges because of a lack of sidewalks, ramps, functioning lifts and small indoor spaces. Conclusion: Mothers of children with CP feel socially isolated owing to a lack of support from family, community members, and health care providers. This social isolation was exacerbated by attitudes of others towards the mothers; it was felt that mothers were responsible for their children’s condition. Mothers also experienced marital problems as a result of having a child with CP.

  12. Simulation-based crisis resource management training for pediatric critical care medicine: a review for instructors.

    Science.gov (United States)

    Cheng, Adam; Donoghue, Aaron; Gilfoyle, Elaine; Eppich, Walter

    2012-03-01

    To review the essential elements of crisis resource management and provide a resource for instructors by describing how to use simulation-based training to teach crisis resource management principles in pediatric acute care contexts. A MEDLINE-based literature source. OUTLINE OF REVIEW: This review is divided into three main sections: Background, Principles of Crisis Resource Management, and Tools and Resources. The background section provides the brief history and definition of crisis resource management. The next section describes all the essential elements of crisis resource management, including leadership and followership, communication, teamwork, resource use, and situational awareness. This is followed by a review of evidence supporting the use of simulation-based crisis resource management training in health care. The last section provides the resources necessary to develop crisis resource management training using a simulation-based approach. This includes a description of how to design pediatric simulation scenarios, how to effectively debrief, and a list of potential assessment tools that instructors can use to evaluate crisis resource management performance during simulation-based training. Crisis resource management principles form the foundation for efficient team functioning and subsequent error reduction in high-stakes environments such as acute care pediatrics. Effective instructor training is required for those programs wishing to teach these principles using simulation-based learning. Dissemination and integration of these principles into pediatric critical care practice has the potential for a tremendous impact on patient safety and outcomes.

  13. Kangaroo Mother Care Management of a 750 Ggrammes Baby: A ...

    African Journals Online (AJOL)

    This paper presents the successful management of 750 grammes low birth weight baby using kangaroo mother care in the hospital and at home. The baby had suffered a variety of morbidities associated with prematurity in the early neonatal period. Key words: Kangaroo mother care, low birth weight babies ...

  14. Nonmaternal Care's Association With Mother's Parenting Sensitivity: A Case of Self-Selection Bias?

    Science.gov (United States)

    Nomaguchi, Kei M; Demaris, Alfred

    2013-06-01

    Although attachment theory posits that the use of nonmaternal care undermines quality of mothers' parenting, empirical evidence for this link is inconclusive. Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development ( N = 1,233), the authors examined the associations between nonmaternal care characteristics and maternal sensitivity during the first 3 years of children's lives, with special attention to selection effects and moderation by resource levels. Findings from fixed-effects regression models suggested that, on average, there is little relationship between nonmaternal care characteristics and maternal sensitivity, once selection factors are held constant. Some evidence of moderation effects was found, however. Excellent-quality care is related to more sensitivity for mothers with lower family income. Poor-quality care is related to lower sensitivity for single mothers, but not partnered mothers. In sum, nonmaternal care characteristics do not seem to have as much influence on mothers' parenting as attachment theory claims.

  15. Mothers' health services utilization and health care seeking ...

    African Journals Online (AJOL)

    Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...

  16. Reconciliation of work and care among lone mothers of adults with intellectual disabilities: the role and limits of care capital.

    Science.gov (United States)

    Chou, Yueh-Ching; Kröger, Teppo

    2014-07-01

    In this study, the concept of social capital is applied to an exploration of Guanxi (social networking to create good relationships) among working lone mothers of adults with intellectual disabilities (ID) in Taiwan. Using in-depth interviews, this study explores the role of social capital, here referred to as 'care capital', in making it possible for working lone mothers to combine their roles as family carers and workers. Eleven divorced or widowed mothers combining their paid work with long-term care responsibilities were recruited from a survey or through NGOs and were interviewed at their home between October 2008 and July 2010. An interpretative phenomenological approach was adopted for data analysis. The findings revealed that the mothers' care capital was extremely limited and was lost, gained and lost again during their life-cycles of long-term care-giving. Guanxi, especially in relation to their employers, proved to be the sole source of care capital for these mothers, making reconciliation between work and care responsibilities possible. In the absence of formal or informal support, religion and the mother-child relationship seemed also to become a kind of care capital for these lone mothers, helping them to get by with their life-long care responsibilities. For formal social and healthcare services, not just in Taiwan but in every country, it is important to develop support for lone mothers of adults with ID who have long-term care responsibilities and low levels of care capital and thus face care poverty. © 2014 John Wiley & Sons Ltd.

  17. Difficulties of care-work reconciliation: employed and nonemployed mothers of children with intellectual disability.

    Science.gov (United States)

    Chou, Yueh-Ching; Fu, Li-Yeh; Pu, Cheng-Yun; Chang, Heng-Hao

    2012-09-01

    Whether employed and nonemployed mothers of children with intellectual disability (ID) have different experiences with reconciliation between care and work has rarely been explored. A survey was conducted in a county in Taiwan and 487 mothers aged younger than 65 and having a child with ID were interviewed face to face at their homes to explore whether there are different factors related to the reconciliation between care and work among employed and nonemployed mothers. Except for the common ground of mothers' health and care demands, logistic regression revealed work flexibility and care support were important for employed mothers. In contrast, the success of reconciliation for nonemployed mothers was determined by their individual characteristics (i.e., age, marital status, family income). Reconciliation policies for mothers with different employment statuses need to use different strategies.

  18. The Burden of Care: Mothers' Experiences of Children with Congenital Heart Disease.

    Science.gov (United States)

    Sabzevari, Sakinne; Nematollahi, Monirsadat; Mirzaei, Tayebeh; Ravari, Ali

    2016-10-01

    Mothers play a key role in caring for their sick children. Their experiences of care were influenced by culture, rules, and the system of health and care services. There are few studies on maternal care of children with congenital heart disease. Also, each of them has studied a particular aspect of care. The present research aimed to understand care experiences of mothers of children with congenital heart disease. A conventional content analysis was used to obtain rich data. The goal of content analysis is "to provide knowledge and deeper understanding of the phenomenon under the study". The study was conducted in Kerman, Iran in 2014, on mothers of children with CHD. The purposive sampling technique was used to select the participants. Participants were 14 mothers of children with CHD and one father and one nurse of open heart surgery unit, from two hospitals affiliated with Kerman University of Medical Sciences. Eighteen semi-structured interviews were constructed. Data were analyzed using conventional content analysis. MAXQDA 2007 software (VERBI GmbH, Berlin, Germany) was used to classify and manage the coding. Constant comparative method was done for data analysis. The reliability and validity of the findings, including the credibility, confirm ability, dependability, and transferability, were assessed. According to the content analysis, the main theme was the catastrophic burden of child care on mothers that included three categories: 1) the tension resulting from the disease, 2) involvement with internal thoughts, and 3) difficulties of care process. The results of this study may help health care professionals to provide supportive and educational packages to the patients, mothers and Family members until improving the management of patient's care.

  19. Postpartum home care and its effects on mothers' health: A clinical trial

    Directory of Open Access Journals (Sweden)

    Hourieh Shamshiri Milani

    2017-01-01

    Full Text Available Background: Postpartum home care plays an important role in prevention of postpartum complications. Regular visits of mothers during this period are imperative. This study aimed to provide postpartum home care for mothers to assess its effects on mothers' health in Iran. Materials and Methods: This study was carried out in two phases. First, a comprehensive postpartum home care program was compiled by performing a comparative study, using the available guidelines in this regard in different countries and based on the opinions of the experts. Next, a clinical trial was carried out on 276 women who gave birth in the university hospitals affiliated to Shahid Beheshti University of Medical Sciences. There were 92 mothers in the intervention and 184 in the control group. The intervention group mothers were provided with postpartum home care service while the control group did not receive such a service. Results: Outcome assessment at 60 days' postpartum revealed a significant difference between the two groups in terms of the use of supplements, birth control methods, postpartum depression, breastfeeding problems, constipation, and fatigue (P 0.05. Conclusion: The postpartum home care program had a positive effect on some aspects of the mothers' health status and their satisfaction in our society.

  20. Competitive mothering and delegated care: Class relationships in nanny and au pair employment

    Directory of Open Access Journals (Sweden)

    Rosie Cox

    2011-07-01

    Full Text Available This paper uses the idea of 'competitive care' to explore how the mothering projects of nanny and au pair employers and the carers they employ can become inter-twined and yet may also be in conflict or competition. The paper draws on work by Cameron Lynne Macdonald (2010 and Joan Tronto (2006 to make two arguments about the inter-twining of current practices of competitive mothering and the employment of nannies and au pairs. First, practices of competitive mothering can underpin the demand for paid, privatized care in the home (such as nannies and au pairs and involve middle class / advantaged women using their position to raise their children in ways which are specifically designed to ensure and enhance their children's future social status and income. This can be at the cost of the mothering projects (and children of the women they employ. Second, one factor which underlies the prevalence of competitive mothering within certain middle class families is the conflict that working mothers feel about their roles and their strong desire to address these conflicts by showing that their children do not suffer because of their employment. The emphasis on care for children as mothering, rather than parenting – or better still 'care' – underpins this sense of conflict. The idea that it is mothers, rather than parents or society at large, who are delegating care is an important element in the organisation of care, and the relationships with carers that ensue.

  1. Chicago Mothers on Finding and Using Child Care during Nonstandard Work Hours

    Science.gov (United States)

    Stoll, Marcia; Alexander, David; Nicpon, Christine

    2015-01-01

    Few issues confound child care policy more than the fact that very large numbers of mothers work evenings, overnight, or weekend hours when fewer child care programs operate. The authors interviewed 50 single Chicago mothers with nontraditional work hours about their experiences finding and using child care. Participants' responses addressed…

  2. Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care.

    Science.gov (United States)

    Paton, Fiona; Wright, Kath; Ayre, Nigel; Dare, Ceri; Johnson, Sonia; Lloyd-Evans, Brynmor; Simpson, Alan; Webber, Martin; Meader, Nick

    2016-01-01

    Crisis Concordat was established to improve outcomes for people experiencing a mental health crisis. The Crisis Concordat sets out four stages of the crisis care pathway: (1) access to support before crisis point; (2) urgent and emergency access to crisis care; (3) quality treatment and care in crisis; and (4) promoting recovery. To evaluate the clinical effectiveness and cost-effectiveness of the models of care for improving outcomes at each stage of the care pathway. Electronic databases were searched for guidelines, reviews and, where necessary, primary studies. The searches were performed on 25 and 26 June 2014 for NHS Evidence, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database, and the Health Technology Assessment (HTA) and PROSPERO databases, and on 11 November 2014 for MEDLINE, PsycINFO and the Criminal Justice Abstracts databases. Relevant reports and reference lists of retrieved articles were scanned to identify additional studies. When guidelines covered a topic comprehensively, further literature was not assessed; however, where there were gaps, systematic reviews and then primary studies were assessed in order of priority. Systematic reviews were critically appraised using the Risk Of Bias In Systematic reviews assessment tool, trials were assessed using the Cochrane risk-of-bias tool, studies without a control group were assessed using the National Institute for Health and Care Excellence (NICE) prognostic studies tool and qualitative studies were assessed using the Critical Appraisal Skills Programme quality assessment tool. A narrative synthesis was conducted for each stage of the care pathway structured according to the type of care model assessed. The type and range of evidence identified precluded the use of meta-analysis. One review of reviews, six systematic reviews, nine guidelines and 15 primary studies were included. There was very limited evidence for access to support

  3. Impact of media health campaign for primary health care among mothers in karachi

    International Nuclear Information System (INIS)

    Habibullah, S.

    2008-01-01

    To evaluate the knowledge, attitude and practice of media-based primary health care (i.e. Expanded Programme of Immunization, National Polio Day, oral rehydration therapy, breast feeding, contraceptive practices, modes of spread of hepatitis B, C, and HIV) among mothers with children under five years of age in an urban and a rural area of Karachi and changes in the same after community-based health education The study was conducted in two phases. In the first phase 600 mothers with children under five years of age were selected at random (300 urban and 300 rural) for the evaluation of knowledge, attitude and practice of media-based primary health care i.e. Expanded Programme of Immunization, National Polio Day, oral rehydration therapy, breast feeding, contraceptive practices and modes of spread of Hepatitis B, C and HIV. In the second phase, health education on the same components of primary health care was given by lady health workers of the area to the same community for one month. Data of 200 mothers (100 urban and 100 rural) was re-evaluated after three months, to find out if there was any change, in the same. All the three areas were given scores and grade. In this study, 58% were Sindhi speaking. The mean age of mothers was 29 years. Majority (91% urban and 45% rural mothers) had access to one or more media channels. The knowledge of media-based primary health care was poor (score=10.09) among all mothers but attitude (score=8.07) and practice (score=11.09) was good for the same in more than 70% mothers in both communities. In the second phase of the study, it was found that the knowledge of primary health care had not improved but attitude and practice was good as observed earlier in both communities. Despite the national media based health education of Primary Health Care for decades, knowledge of primary health care was poor among mothers (urban and rural) but attitude and practice was good. Age and exposure to one or more media channels was found

  4. Evaluating multidisciplinary health care teams: taking the crisis out of CRM.

    Science.gov (United States)

    Sutton, Gigi

    2009-08-01

    High-reliability organisations are those, such as within the aviation industry, which operate in complex, hazardous environments and yet despite this are able to balance safety and effectiveness. Crew resource management (CRM) training is used to improve the non-technical skills of aviation crews and other high-reliability teams. To date, CRM within the health sector has been restricted to use with "crisis teams" and "crisis events". The purpose of this discussion paper is to examine the application of CRM to acute, ward-based multidisciplinary health care teams and more broadly to argue for the repositioning of health-based CRM to address effective everyday function, of which "crisis events" form just one part. It is argued that CRM methodology could be applied to evaluate ward-based health care teams and design non-technical skills training to increase their efficacy, promote better patient outcomes, and facilitate a range of positive personal and organisational level outcomes.

  5. Critical care nurses' experiences of nursing mothers in an ICU after complicated childbirth.

    Science.gov (United States)

    Engström, Asa; Lindberg, Inger

    2013-09-01

    Providing nursing care for a critically ill obstetric patient or a patient who has just become a mother after a complicated birth can be a challenging experience for critical care nurses (CCNs). These patients have special needs because of the significant alterations in their physiology and anatomy together with the need to consider such specifics as breastfeeding and mother-child bonding. The aim with this study was to describe CCNs' experience of nursing the new mother and her family after a complicated childbirth. The design of the study was qualitative. Data collection was carried out through focus group discussions with 13 CCNs in three focus groups during spring 2012. The data were subjected to qualitative content analysis. The analysis resulted in the formulation of four categories: the mother and her vital functions are prioritized; not being responsible for the child and the father; an environment unsuited to the new family and collaboration with staff in neonatal and maternity delivery wards. When nursing a mother after a complicated birth the CCNs give her and her vital signs high priority. The fathers of the children or partners of the mothers are expected to take on the responsibility of caring for the newborn child and of being the link with the neonatal ward. It is suggested that education about the needs of new families for nursing care would improve the situation and have clinical implications. Whether the intensive care unit is always the best place in which to provide care for mothers and new families is debatable. © 2013 British Association of Critical Care Nurses.

  6. Good short-term outcome of kangaroo mother care in low birth ...

    African Journals Online (AJOL)

    Good short-term outcome of kangaroo mother care in low birth weight infants in a rural South African hospital. A N Rodriguez, M Nel, H Dippenaar, E A Prinsloo. Abstract. Objective: The aim of the study was to determine the outcome of kangaroo mother care (KMC) in low birth weight infants at a community hospital. Methods ...

  7. Spiritual Care Training for Mothers of Children with Cancer: Effects on Quality of Care and Mental Health of Caregivers.

    Science.gov (United States)

    Borjalilu, Somaieh; Shahidi, Shahriar; Mazaheri, Mohammad Ali; Emami, Amir Hossein

    2016-01-01

    The purpose of this study was to explore the effectiveness of a spiritual care training package in maternal caregivers of children with cancer. This study was a quasi-experimental study with pretest and posttest design consisting of a sample of 42 mothers of children diagnosed as having cancer. Participants were randomly assigned to either an experimental or a control group. The training package consisted of seven group training sessions offered in a children's hospital in Tehran. All mothers completed the Spirituality and Spiritual Care Rating Scale (SSCRS) and the Depression, Anxiety and Stress Scale (DASS-21) at pre and post test and after a three month follow up. There was significant difference between anxiety and spiritual, religious, Personalized care and total scores spiritual care between the intervention and control groups at follow-up (Pspiritual care training program promotes spirituality, personalized care, religiosity and spiritual care as well as decreasing anxiety in mothers of children with cancer and decreases anxiety. It may be concluded that spiritual care training could be used effectively in reducing distressful spiritual challenges in mothers of children with cancer.

  8. Culture and maternity care in Kazakhstan: what new mothers expected.

    Science.gov (United States)

    Craig, Brett J; Kabylbekova, Zhanar

    2015-01-01

    Maternity care in the developing nation of Kazakhstan has been characterized as low in quality, with mothers having low levels of health knowledge. Some nongovernmental organizations have been offering childbirth preparation courses to address the lack of knowledge and encourage participation and decision making among expecting mothers. The participants of this study, however, report that information is more for preparation than for decision making, and that the relational aspects of their care, namely, emotional support and trust, are most important. This emphasis reflects the cultural and historical influences that need to be considered when adopting foreign models of care and health education.

  9. Evaluating Home Day Care Mothers' Work with Young Children.

    Science.gov (United States)

    Seattle Community Coll., Washington.

    This checklist was developed to determine the skills of day care home mothers before and after training as observed by a day care home educator. Areas evaluated are: Professional Attitude; Parent Relationships; Nutrition; Health and Safety; Baby Care; Preparing the Teaching Environment; Guidance; Teaching Techniques, Language and Literature; Art;…

  10. Care and secrecy: being a mother of children living with HIV in Burkina Faso.

    Science.gov (United States)

    Hejoaka, Fabienne

    2009-09-01

    Home care has become a central component of the response to the HIV/AIDS epidemic, displacing caregiving work onto women. While increasing interest has been paid to HIV/AIDS care with a focus on ailing adults and orphan foster care, the issue of caring for children living with HIV has received little attention in the social sciences. Based on ethnographic material gathered in Burkina Faso between November 2005 and December 2006, the aim of this paper was to gain understanding of women who mother and care for children living with HIV in resource-limited countries. The study involved participant observation in community-based organizations in Burkina Faso and semi-structured interviews with 20 women mothering HIV-positive children as well as 15 children infected with HIV, aged between 8 and 18 years. In daily care mothers face many great challenges, ranging from the routine of pill-taking to disturbing discussions with children asking questions about their health or treatment. The results also show how HIV/AIDS-related stigma adds an additional layer to the burden of care, compelling mothers to deal with the tension between secrecy surrounding the disease and the openness required in providing care and receiving social support. As mothers live in fear of disclosure, they have to develop concealment strategies around children's treatment and the nature of the disease. Conversely, some mothers may share their secret with kin members, close relatives or their children to gain social support. As HIV/AIDS care is shaped by secrecy, these findings shed light on mothers' isolation in child care within a context of changing patterns of family bonds and lack of formal psychosocial support addressing child-related issues. Finally, women's engagement in child care invites us to look beyond the essentialist approach of women's vulnerability conveyed by international discourse to characterise the situation of women facing the HIV/AIDS impact.

  11. WORKING MOTHERS AND THE NEED FOR CHILD CARE SERVICES.

    Science.gov (United States)

    Women's Bureau (DOL), Washington, DC.

    DATA AND CHARTS DOCUMENT THE RISING NUMBER OF WORKING MOTHERS IN THE UNITED STATES TODAY AND THE INCREASING NEED FOR CHILD CARE SERVICES. DATA WERE OBTAINED FROM U.S. DEPARTMENTS OF LABOR, COMMERCE, AND HEALTH, EDUCATION, AND WELFARE. NEARLY 10 MILLION MOTHERS WITH CHILDREN UNDER 18 YEARS OF AGE WERE WORKERS IN MARCH 1966. MORE THAN ONE OF THREE…

  12. Impact of mothers' employment on infant feeding and care: a qualitative study of the experiences of mothers employed through the Mahatma Gandhi National Rural Employment Guarantee Act.

    Science.gov (United States)

    Nair, Manisha; Ariana, Proochista; Webster, Premila

    2014-04-02

    To explore the experiences of mothers employed through the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) using focus group discussions (FGDs) to understand the impact of mothers' employment on infant feeding and care. The effects of mothers' employment on nutritional status of children could be variable. It could lead to increased household income, but could also compromise child care and feeding. The study was undertaken in the Dungarpur district of Rajasthan, India. Mothers of infants employment compromises infant feeding and care', 'caregivers' inability to substitute mothers' care', 'compromises related to childcare and feeding outweigh benefits from MGNREGA' and 'employment as disempowering'. Mothers felt that the comprises to infant care and feeding due to long hours of work, lack of alternative adequate care arrangements, low wages and delayed payments outweighed the benefits from the scheme. This study provides an account of the trade-off between mothers' employment and child care. It provides an understanding of the household power relationships, societal and cultural factors that modulate the effects of mothers' employment. From the perspective of mothers, it helps to understand the benefits and problems related to providing employment to women with infants in the MGNREGA scheme and make a case to pursue policy changes to improve their working conditions.

  13. Implementation of Kangaroo mother care by health workers in Nigeria

    African Journals Online (AJOL)

    2016-08-04

    Aug 4, 2016 ... thermia, hypoglycemia and nosocomial sepsis in neo- nates with birth weight ... for care for preterm babies with few neonatal care units, located often in .... Fig 2: Reasons for not practicing Kangaroo Mother Care in facilities of ...

  14. Newborn cord care practices amongst mothers in Port Harcourt ...

    African Journals Online (AJOL)

    Information obtained included biodata, age and sex of last baby, social class, place of antenatal care and delivery, and cord care practices. Data were analysed using SPSS version 16.0. Results: Two hundred and ten mothers participated in the study. 71.9% were of high social class. Over 80% received antenatal care in ...

  15. Electronic communication preferences among mothers in the neonatal intensive care unit.

    Science.gov (United States)

    Weems, M F; Graetz, I; Lan, R; DeBaer, L R; Beeman, G

    2016-11-01

    Mobile communication with the medical-care team has the potential to decrease stress among parents of infants admitted to the neonatal intensive care unit (NICU). We assessed mobile use and communication preferences in a population of urban minority NICU mothers. A 30-question English language survey was administered to mothers of NICU patients. The survey was completed by 217 mothers, 75% were Black, and 75% reported annual household income below $20 000. Only 56% had a computer with Internet access at home, but 79% used smartphones. Most (79%) have searched the Internet for health information in the past year. Receiving electronic messages about their babies was viewed favorably, and text messaging was the preferred platform. The majority of mothers felt electronic messaging would improve communication but should not replace verbal communication. Mobile communication is used widely in this population of NICU mothers and could potentially improve provider-parent communication and reduce parental stress.

  16. Myasthenic crisis patients who require intensive care unit management.

    Science.gov (United States)

    Sakaguchi, Hideya; Yamashita, Satoshi; Hirano, Teruyuki; Nakajima, Makoto; Kimura, En; Maeda, Yasushi; Uchino, Makoto

    2012-09-01

    The purpose of this report was to investigate predictive factors that necessitate intensive care in myasthenic crisis (MC). We retrospectively reviewed MC patients at our institution and compared ICU and ward management groups. Higher MG-ADL scale scores, non-ocular initial symptoms, infection-triggered findings, and higher MGFA classification were observed more frequently in the ICU group. In patients with these prognostic factors, better outcomes may be obtained with early institution of intensive care. Copyright © 2012 Wiley Periodicals, Inc.

  17. Health Care Factors Influencing Teen Mothers' Use Of Contraceptives in Malawi.

    Science.gov (United States)

    Machira, Kennedy; Palamuleni, Martin E

    2017-06-01

    The study seeks to examine factors associated with teen mothers' use of modern contraceptives after giving birth. The 2010 Malawi Demographic and Health Survey data was used to test the study objective. A sample of 12, 911 teen mothers aged between 10 and 18 years were extracted from 23, 020 women and were asked of contraceptive usage after first birth experiences, in which, a logistic regression model was employed to estimate correlates of contraceptive usage. The study found that 54.8% of the teen mothers are still at a risk of having a repeat teenage pregnancy due to their non-use of contraceptives. This implies that less than 50% of teen mothers use contraceptives after experiencing teen birth. It is noted that health care factors such as use of antenatal care, awareness of pregnancy complications, attainment of primary education and exposure to media predict teen mothers' use of modern contraceptives. Despite endeavours made by government to improve access to family planning, health care challenges still exist affecting women's use of contraceptives in Malawi. Ameliorating these health encounters call for wide-range approaches aimed at addressing teen birth comprehensively in order to prevent early motherhood and subsequently high fertility. None declared.

  18. Home care after early discharge: impact on healthy mothers and newborns.

    Science.gov (United States)

    Askelsdottir, Björk; Lam-de Jonge, Willemien; Edman, Gunnar; Wiklund, Ingela

    2013-08-01

    to compare early discharge with home care versus standard postpartum care in terms of mothers' sense of security; contact between mother, newborn and partner; emotions towards breast feeding; and breast-feeding duration at one and three months after birth. retrospective case-control study. a labour ward unit in Stockholm, Sweden handling both normal and complicated births. 96 women with single, uncomplicated pregnancies and births, and their healthy newborns. early discharge at 12-24 hours post partum with 2-3 home visits during the first week after birth. The intervention group consisted of women who had a normal vaginal birth (n=45). This group was compared with healthy controls who received standard postnatal care at the hospital (n=51). mothers' sense of security was measured using the Parents' Postnatal Sense of Security Scale. Contact between mother, child and father, and emotions towards breast feeding were measured using the Alliance Scale, and breast-feeding rates at one and three months post partum were recorded. women in the intervention group reported a greater sense of security in the first postnatal week but had more negative emotions towards breast feeding compared with the control group. At three months post partum, 74% of the newborns in the intervention group were fully breast fed versus 93% in the control group (p=0.021). Contact between the mother, newborn and partner did not differ between the groups. early discharge with home care is a feasible option for healthy women and newborns, but randomised controlled studies are needed to investigate the effects of home care on breast-feeding rates. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Evaluation of the Knowledge and Attitude Changes of Mothers in Neonatal Care

    Directory of Open Access Journals (Sweden)

    Şahin Hamilçıkan

    2017-06-01

    Full Text Available Aim: The aim was to determine the initial knowledge of mothers about neonatal care and evaluate their knowledge, care and attitude changes following individual education. Materials and Methods: Questionnaire forms designed on the subject of infant care and nutrition were given to mothers right after delivery. Before being discharged they were informed by the doctor and breastfeeding nurse about nutrition, infant care, and the most common mistakes. These forms were reapplied on the 15th and 30th days in neonatal polyclinic controls and the changes were evaluated. The correct information was repeated to the mothers who were detected to have misinformation and wrong attitudes in the evaluations in each form application period. Results: A total of 100 mothers and their infants were included in the study. No difference was determined in the nutrition rates of infants with food other than breast milk on the first day, 15th and 30th days. However, the breastfeeding rates obtained were higher on the 30th day than on the 15th, with an interval of two hours, and in general breastfeeding rates were low on the 15th and 30th days. The rates of bathing the infants with and without a bathtub net were determined to be high on the 15th and 30th days. The change in the infants’ sleeping positions, the place of sleep, and the presence of rails/guards around the crib on the 15th and 30th days were not found to be significant compared to the 1st day. There was a significant increase in the umbilical care rates on the 15th and 30th days. The increase in washing the clothes of the infants with soap powder, and the decrease in swaddling after the education were found to be significant. Furthermore, it was determined that the mothers received infant care information more frequently from the healthcare organisation on the 15th and 30th days compared to the 1st day. The highest correlation between the maternal education level and the post-education knowledge and

  20. Impact of the mother-nurse partnership programme on mother and infant outcomes in paediatric cardiac intensive care unit.

    Science.gov (United States)

    Uhm, Ju-Yeon; Kim, Hee Soon

    2018-04-04

    To identify the effects of a mother-nurse partnership programme based on the core components of information sharing, negotiation and participation in care. Specifically, we examined the programme's effects on parental satisfaction, parental self-efficacy, perceived partnership and anxiety, as well as infants' time to reach full oral feeding and length of postoperative hospital stay, following cardiac surgery on infants at a paediatric intensive care unit with a restrictive visiting policy. Quasi-experimental study. An analysis of covariance was used to investigate between-group differences while ensuring homogeneity. A paediatric cardiac ICU. Parental satisfaction, parental self-efficacy, perceived partnership and anxiety. Data from 37 and 36 mothers in the control and experimental groups respectively, were analysed. Compared with controls, experimental group mothers reported significantly higher parental satisfaction (F = 39.29, p partnership (F = 62.30, p < .001) and lower anxiety (F = 12.93, p < .001), upon transfer to the ward. Infant outcomes did not differ between the groups. This programme appears to facilitate collaboration between nurses and mothers and positively influences mothers' emotional and cognitive outcomes following infants' cardiac surgery. Copyright © 2018. Published by Elsevier Ltd.

  1. [Day-care mother--a successful model of child rearing?].

    Science.gov (United States)

    Schetelig, H

    1977-02-17

    The scientific reports published so far on the project "day care mothering" do not allow to draw scientific conclusions, whether this educational model can achieve nearly equal results as family education. The author critisises, that such a clame is made. It seems necessary, to pay more importance to the function of the mother for her children, to give the children a sound emotional basis for their future development.

  2. Infant Care in England: Mothers' Aspirations, Experiences, Satisfaction and Caregiver Relationships

    Science.gov (United States)

    Barnes, Jacqueline; Leach, Penelope; Sylva, Kathy; Stein, Alan; Malmberg, Lars-Erik

    2006-01-01

    This paper investigates non-maternal infant care in the first year of life, examining the relationships between child care ideals, attitudinal, sociodemographic and psychological characteristics of mothers at three months postpartum and their child care experiences at 10 months. Predictors of child care use, satisfaction with non-maternal care and…

  3. The perception of fairness in infant care and mothers' postpartum depression.

    Science.gov (United States)

    DeMaris, Alfred; Mahoney, Annette

    2017-10-01

    This study investigates a potential causal effect of mothers' perceptions of the fairness of infant care on their postpartum depression. Based on the tenets of equity theory, it is hypothesized that, net of controls, mothers who see infant care as fairly apportioned between themselves and their husbands will be less depressed than others. We utilize data from a longitudinal study of a nonrandom sample of 178 heterosexual couples experiencing the birth of their first child together. The primary focus variable is the mothers' perception in the first couple of months postpartum that infant care is fair to them. Statistical analysis involved the careful chronological sequencing of response variable and controls, along with regression modeling using propensity scores. We find that a perception of fairness is associated with about a quarter of a standard deviation lower depressive symptomatology, controlling for key covariates. Depressive symptomatology is additionally elevated for mothers experiencing more pre-partum depression, and for those who more generally felt, before the birth, that they were overbenefiting in the marriage. This paper contributes to both equity theory and research on postpartum depression. In a scenario in which it is not practical or ethical to randomly assign people to fairness-in-infant-care conditions, we are able to utilize longitudinal data and a natural "experiment," along with propensity-score modeling to attempt to assess the causal impact of fairness in infant care on postpartum depression. The finding that fairness in this arena appears to reduce postpartum depression emphasizes the importance of encouraging father participation in this critical stage of parenting. Limitations of the study with respect to causal inference are also discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. The crisis of capitalism and the marketization of health care: the implications for public health professionals

    Directory of Open Access Journals (Sweden)

    Martin McKee

    2012-12-01

    Full Text Available The current economic crisis in Europe has challenged the basis of the economic model that currently prevails in much of the industrialised world. It has revealed a system that is managed not for the benefit of the people but rather for corporations and the small elite who lead them and which is clearly unsustainable in its present form. Yet, there is a hidden consequence of this system: an unfolding crisis in health care, driven by the greed of corporations whose profit-seeking model is also failing. Proponents of commodifying healthcare simultaneously argue that the cost of providing care for ageing populations is unaffordable while working to create demand for their health care products among those who are essentially healthy. Will healthcare be the next profit-fuelled investor bubble? In this paper we call on health professionals to heed the warnings from the economic crisis and, rather than stand by while a crisis unfolds, act now to redirect increasingly market-oriented health systems to serve the common good.

  5. The crisis of capitalism and the marketisation of health care: the implications for public health professionals.

    Science.gov (United States)

    McKee, Martin; Stuckler, David

    2012-12-28

    The current economic crisis in Europe has challenged the basis of the economic model that currently prevails in much of the industrialised world. It has revealed a system that is managed not for the benefit of the people but rather for the corporations and the small elite who lead them, and which is clearly unsustainable in its present form. Yet, there is a hidden consequence of this system: an unfolding crisis in health care, driven by the greed of corporations whose profit-seeking model is also failing. Proponents of commodifying healthcare simultaneously argue that the cost of providing care for ageing populations is unaffordable while working to create demand for their health care products among those who are essentially healthy. Will healthcare be the next profit-fuelled investor bubble? In this paper, we call on health professionals to heed the warnings from the economic crisis and, rather than stand by while a crisis unfolds, act now to redirect increasingly market-oriented health systems to serve the common good.

  6. Infant Feeding and Care Practices of Mothers in Igbesa and its ...

    African Journals Online (AJOL)

    Objectives: The study examined the practice of exclusive breastfeeding and its duration; complementary feeding and care practices of the mothers. Subjects and Methods: Two hundred nursing mothers were randomly selected from the ten communities that make up the area under study. Data were collected using a ...

  7. Clever mothers balance time and effort in parental care: a study on free-ranging dogs.

    Science.gov (United States)

    Paul, Manabi; Sau, Shubhra; Nandi, Anjan K; Bhadra, Anindita

    2017-01-01

    Mammalian offspring require parental care, at least in the form of nursing during their early development. While mothers need to invest considerable time and energy in ensuring the survival of their current offspring, they also need to optimize their investment in one batch of offspring in order to ensure future reproduction and hence lifetime reproductive success. Free-ranging dogs live in small social groups, mate promiscuously and lack the cooperative breeding biology of other group-living canids. They face high early-life mortality, which in turn reduces fitness benefits of the mother from a batch of pups. We carried out a field-based study on free-ranging dogs in India to understand the nature of maternal care. Our analysis reveals that mothers reduce investment in energy-intensive active care and increase passive care as the pups grow older, thereby keeping overall levels of care more or less constant over pup age. Using the patterns of mother-pup interactions, we define the different phases of maternal care behaviour.

  8. Shedding Further Light on the Effects of Various Types and Quality of Early Child Care on Infant-Mother Attachment Relationship: The Haifa Study of Early Child Care.

    Science.gov (United States)

    Sagi, Abraham; Koren-Karie, Nina; Gini, Motti; Ziv, Yair; Joels, Tirtsa

    2002-01-01

    The Haifa Study of Early Child Care examined the unique contribution of various child-care-related correlates to infant-mother attachment. Findings indicated that, after controlling for other potential contributing variables (including mother characteristics, mother-child interaction, and mother- father relationship), center care adversely…

  9. Prenatal care utilization for mothers from low-income areas of New Mexico, 1989-1999.

    Directory of Open Access Journals (Sweden)

    Michael A Schillaci

    2010-09-01

    Full Text Available Prenatal care is considered to be an important component of primary health care. Our study compared prenatal care utilization and rates of adverse birth outcomes for mothers from low- and higher-income areas of New Mexico between 1989 and 1999.Prenatal care indicators included the number of prenatal care visits and the first month of prenatal care. Birth outcome indicators included low birth weight, premature birth, and births linked with death certificates. The results of our study indicated that mothers from low-income areas started their prenatal care significantly later in their pregnancies between 1989 and 1999, and had significantly fewer prenatal visits between 1989 and 1997. For the most part, there were not significant differences in birth outcome indicators between income groupings.These findings suggest that while mothers from low-income areas received lower levels of prenatal care, they did not experience a higher level of adverse birth outcomes.

  10. Development and evaluation of a newborn care education programme in primiparous mothers in Nepal.

    Science.gov (United States)

    Shrestha, Sharmila; Adachi, Kumiko; Petrini, Marcia A; Shrestha, Sarita; Rana Khagi, Bina

    2016-11-01

    the health and survival of newborns depend on high levels of attention and care from caregivers. The growth and development of some infants are unhealthy because of their mother's or caregiver's lack of knowledge or the use of inappropriate or traditional child-rearing practices that may be harmful. to develop a newborn care educational programme and evaluate its impact on infant and maternal health in Nepal. a randomised controlled trial. one hundred and forty-three mothers were randomly assigned to the intervention (n=69) and control (n=74) groups. Eligible participants were primiparous mothers who had given birth to a single, full-term, healthy infant, and were without a history of obstetric, medical, or psychological problems. prior to being discharged from the postnatal unit, the intervention group received our structured newborn care education programme, which consisted of one-on-one educational sessions lasting 10-15minutes each and one postpartum follow-up telephone support within two weeks after discharge, in addition to the hospital's routine general newborn care education. The control group received only the regular general newborn care education. Outcomes were measured by using Newborn care Knowledge Questionnaires, Karitane Parenting Confidence Scale, State-Trait Anxiety Inventory for Adults and infant health and care status. the number of mothers attending the health centre due to the sickness of their babies was significantly decreased in the intervention group compared to the control group. Moreover, the intervention group had significant increases in newborn care knowledge and confidence, and decreases in anxiety, compared with the control group. the structured newborn care education programme enhanced the infant and mother health. Moreover, it increased maternal knowledge of newborn care and maternal confidence; and reduced anxiety in primiparous mothers. Thus, this educational programme could be integrated into routine educational programs to

  11. Mental health care needs and preferences for mothers of children with a disability.

    Science.gov (United States)

    Gilson, K-M; Davis, E; Johnson, S; Gains, J; Reddihough, D; Williams, K

    2018-05-01

    Mothers of children with a disability are at increased risk of poor mental health compared with mothers of typically developing children. The aim of the study was to describe the mental health care needs and preferences for support of mothers of children and young people aged 0-25 years with a disability. A cross-sectional study was used, using an online survey with 294 mothers of children with a disability. Questions were asked about mental health, perceived need for support, barriers to accessing mental health care, and preferences for support. Descriptive and chi-squared analyses were performed. High rates of mental ill health were self-identified in the previous 12 months, with reported clinically significant depression (44%), anxiety (42%), and suicidality (22%). Nearly half (48%) of the mothers reported high to very high psychological distress. Although 75% of mothers perceived a need for professional support, only 58% attempted to access this. Key barriers to accessing support were caregiving duties making it difficult to schedule appointments (45%) and not perceiving the mental health problem as serious enough to require help (36%). Individual counselling was the preferred type of support (66%) followed by professionally guided relaxation (49%) and education about mental health (47%). Support was considered most critical at the time of diagnosis and during medical intervention for their child. Although mental health problems were common and mothers perceived the need for professional help, several key barriers were preventing mothers from accessing help. Our study suggests that improving mothers' knowledge of when and where to seek help (mental health literacy) may encourage their access to support. There also needs to be more accessible treatment to mothers given the high care demands that are placed upon them. © 2018 John Wiley & Sons Ltd.

  12. Through the depths and heights of darkness; mothers as patients in psychiatric care.

    Science.gov (United States)

    Blegen, Nina Elisabeth; Eriksson, Katie; Bondas, Terese

    2014-12-01

    This study attempts to contribute to the knowledge of caring science and mental health care by means of a profound understanding of the patients' existential world when being a mother in receipt of psychiatric care, with focus on inner processes such as health and suffering. Mothers struggle to cope with the demands of the illness and the responsibility for their children. They see themselves through their children and regard the child as an important part of themselves. Mothers experience guilt and shame related to motherhood, and when they have to relinquish their responsibility as a mother, they consider themselves a failure. Despite a range of practical and emotional difficulties, motherhood involved extremely positive experiences, which provide a purpose as well as fulfilment and meaning in life. This study is rooted in philosophical hermeneutics inspired by Gadamer with an inductive-deductive-abductive approach. Interpretation of the data was made on different levels of abstraction described as rational, contextual, existential and ontological. The point of departure was the caring science theory about health and suffering and the hermeneutic philosophy of understanding. The interpretation revealed the mothers' experiences of health and suffering as a struggle between the darkness of suffering and their inner source of strength. In the light of the theory of caring, the conscience became visible as the bearer of the human being's inner ethos of love and compassion. Experiences of health and suffering were interpreted as a struggle between guilt and responsibility, where conscience emerged as the road from ontological guilt to responsibility that leads the human being to what is true, beautiful and good in life. © 2014 Nordic College of Caring Science.

  13. Children's early child care and their mothers' later involvement with schools.

    Science.gov (United States)

    Crosnoe, Robert; Augustine, Jennifer March; Huston, Aletha C

    2012-01-01

    Theory and policy highlight the role of child care in preparing children for the transition into school. Approaching this issue in a different way, this study investigated whether children's care experiences before this transition promoted their mothers' school involvement after it, with the hypothesized mechanism for this link being the cultivation of children's social and academic skills. Analyses of 1,352 children (1 month-6 years) and parents in the NICHD Study of Early Child Care and Youth Development revealed that mothers were more involved at their children's schools when children had prior histories of high-quality nonparental care. This pattern, which was fairly stable across levels of maternal education and employment, was mediated by children's academic skills and home environments. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.

  14. Mothers' Transition Back to Work and Infants' Transition to Child Care: Does Work-Based Child Care Make a Difference?

    Science.gov (United States)

    Skouteris, Helen; McCaught, Simone; Dissanayake, Cheryl

    2007-01-01

    The overall aim in this study was twofold: to compare the use of work-based (WB) and non-work-based (NWB) child care on the transition back to the workplace for women after a period of maternity leave, and on the transition into child care for the infants of these women. Thirty-five mothers with infants in WB centres and 44 mothers with infants in…

  15. RELATIONSHIP BETWEEN QUALITY OF CARE OF YOUNG MOTHERS AND SOCIAL-EMOTIONAL DEVELOPMENT IN PRESCHOOL CHILDREN

    Directory of Open Access Journals (Sweden)

    Atik Aryani

    2018-02-01

    Full Text Available Background: Social-emotional development in preschooler children is an important component in child development, as it becomes the foundation in preparing children for confidence, empathy and intellect, building trust, and being able to use language in communication and connect with others. One of the factors that affect children's emotional social development is the quality of mother's care. Children of young mothers have risks in emotional and intellectual social problems in children. Objective: The purpose of the study was to determine the relationship of quality care of young mothers with social-emotional development in preschool children in the working area of the Health Center of Kemalang, Klaten Regency, Indonesia. Methods: This was a correlational analytic research with cross sectional design. The sample of the study was 124 young mothers with preschool children selected using consecutive sampling technique. The study was conducted from July to August 2017 at six kindergarten schools in the working area of the Health Center of Kemalang, Klaten Regency. Data were collected using parent behavior questionnaire and stage social-emotional instrument. Data were analyzed using chi square test. Results: Findings showed that 58.1% of young mothers had good quality of care, and 55.6% of preschoolers were at risk of developing emotional social development problems. There was a significant correlation between the quality of care of young mothers with social-emotional development in preschool children (p-value <0.05. Conclusion: There was a correlation between the quality of care of young mothers with social-emotional development in preschool children.

  16. Effect of Kangaroo Mother Care on Growth and Morbidity Pattern in Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Keerti Swarnkar

    2016-01-01

    Full Text Available Background: Kangaroo Mother Care (KMC is dened as skin-to-skin contact between a mother and her newborn baby derived from practical similarities to marsupial care giving, proximately exclusive breastfeeding and early discharge from hospital. This concept was proposed as an alternative to conventional methods of care for low birth weight (LBW infants, and in replication to quandaries of earnest overcrowding in Neonatal Intensive Care Units (NICUs. KMC essentially utilizes the mother as a natural incubator Aim and Objectives: The aim was to assess the feasibility, acceptability and the effectiveness of KMC in LBW infants. It avoids agitation routinely experienced in busy ward. Material and Methods: A pilot open-labeled quasi-randomised clinical trial was conducted in Level III NICU of a teaching institution. 60 newborn infants <2500 g, meeting inclusion criteria were alternatively randomised into two groups: Kangaroo Mother Care (KMC and Conventional Methods of Care (CMC. Kangaroo mother care was practiced with minimum total period of eight hours a day intermittently for the intervention group while the controls remained in incubators or cots. Weight, head circumference, length, morbidity episodes, hospital stay, feeding patterns were monitored for all infants till postmenstrual age of 42 weeks in preterm babies or till a weight of 2500 g is achieved in term SGA babies. Results: The pilot study conrmed that trial processes were efcient, the intervention was acceptable (to mothers and nurses and that the outcome measures were appropriate; KMC babies achieved signicantly better growth at the end of the study (For preterm babies, weight, length and head circumference gain were signicantly higher in the KMC group (weight 19.28±2.9g/day, length 0.99±0.56cm/week and head circumference 0.72±0.07 cm/week than in the CMC group (P <0.001. A signicantly higher number of babies in the CMC group suffered from hypothermia, hypoglycemia, and

  17. Making work fit care: reconciliation strategies used by working mothers of adults with intellectual disabilities.

    Science.gov (United States)

    Chou, Yueh-Ching; Fu, Li-yeh; Chang, Heng-Hao

    2013-03-01

    This study explored the experiences of working mothers with an adult child with intellectual disabilities to understand how they reconcile paid work and care responsibilities. Fifteen working mothers in Taiwan with an adult child with intellectual disabilities were interviewed, and an interpretative phenomenological approach was adopted for data collection and analysis. All included mothers prioritized their caregiving role over paid work. The strategies used by these mothers to make paid work fit with caregiving included having strong social networks and informal support for their care work, use of formal services, personal religious beliefs and positive attitudes towards care, as well as having flexible working hours due to self-employment, good relations with employers, working positions and work locations. Formal systems, which include both welfare and labour policies, need to be responsive to and involved in supporting these working mothers, especially those who lack good personal networks. © 2012 Blackwell Publishing Ltd.

  18. The life-world of mothers who care for mentally retarded children: the Katutura township experience.

    Science.gov (United States)

    Ntswane, A M; van Rhyn, L

    2007-03-01

    This article reports on a research study done in Katutura Township, near Windhoek. A qualitative, exploratory, descriptive and contextual design was followed to answer the research question investigating experiences of mothers caring for mentally retarded children at home. Phenomenological interviews were conducted with a purposefully selected sample of twelve mothers. The meaning of their experiences was analysed by using Teschxs method (1990 in Creswell, 1994:155) of analysing qualitative data. The results indicated various emotions and challenges experienced by these mothers during the care of their children. Feelings of shock, despondency and sadness dominated the early stages when the retarded children were still young. During later years, as the children were growing up, the mothers felt shame, fear, frustration, anger, disappointment and worry. However, acceptance followed, as the children grew older. Stigma seemed to affect all the respondents. Support in any form or lack thereof seemed to be the decisive factor-positioning mothers along a continuum of two extremes, namely despairing isolation and integrated happiness. Recommendations were made regarding the improvement of heath care services and education of the mothers and their families.

  19. Predictors of Inadequate Prenatal Care in Methamphetamine-Using Mothers in New Zealand and the United States

    Science.gov (United States)

    LaGasse, Linda L.; Wouldes, Trecia A.; Arria, Amelia M.; Wilcox, Tara; Derauf, Chris; Newman, Elana; Shah, Rizwan; Smith, Lynne M.; Neal, Charles R.; Huestis, Marilyn A.; DellaGrotta, Sheri; Lester, Barry M.

    2013-01-01

    This study compared patterns of prenatal care among mothers who used methamphetamine (MA) during pregnancy and non-using mothers in the US and New Zealand (NZ), and evaluated associations among maternal drug use, child protective services (CPS) referral, and inadequate prenatal care in both countries. The sample consisted of 182 mothers in the MA-Exposed and 196 in the Comparison groups in the US, and 107 mothers in the MA-Exposed and 112 in the Comparison groups in NZ. Positive toxicology results and/or maternal report of MA use during pregnancy were used to identify MA use. Information about sociodemographics, prenatal care and prenatal substance use was collected by maternal interview. MA-use during pregnancy is associated with lower socio-economic status, single marital status, and CPS referral in both NZ and the US. Compared to their non-using counterparts, MA-using mothers in the US had significantly higher rates of inadequate prenatal care. No association was found between inadequate care and MA-use in NZ. In the US, inadequate prenatal care was associated with CPS referral, but not in NZ. Referral to CPS for drug use only composed 40 % of all referrals in the US, but only 15 % of referrals in NZ. In our study population, prenatal MA-use and CPS referral eclipse maternal sociodemographics in explanatory power for inadequate prenatal care. The predominant effect of CPS referral in the US is especially interesting, and should encourage further research on whether the US policy of mandatory reporting discourages drug-using mothers from seeking antenatal care. PMID:22588827

  20. Prenatal Care Utilization for Mothers from Low-Income Areas of New Mexico, 1989–1999

    Science.gov (United States)

    Schillaci, Michael A.; Waitzkin, Howard; Carson, E. Ann; Romain, Sandra J.

    2010-01-01

    Background Prenatal care is considered to be an important component of primary health care. Our study compared prenatal care utilization and rates of adverse birth outcomes for mothers from low- and higher-income areas of New Mexico between 1989 and 1999. Methodology/Principal Findings Prenatal care indicators included the number of prenatal care visits and the first month of prenatal care. Birth outcome indicators included low birth weight, premature birth, and births linked with death certificates. The results of our study indicated that mothers from low-income areas started their prenatal care significantly later in their pregnancies between 1989 and 1999, and had significantly fewer prenatal visits between 1989 and 1997. For the most part, there were not significant differences in birth outcome indicators between income groupings. Conclusions/Significance These findings suggest that while mothers from low-income areas received lower levels of prenatal care, they did not experience a higher level of adverse birth outcomes. PMID:20862298

  1. Care around birth, infant and mother health and maternal health investments - Evidence from a nurse strike.

    Science.gov (United States)

    Kronborg, Hanne; Sievertsen, Hans Henrik; Wüst, Miriam

    2016-02-01

    Care around birth may impact child and mother health and parental health investments. We exploit the 2008 national strike among Danish nurses to identify the effects of care around birth on infant and mother health (proxied by health care usage) and maternal investments in the health of their newborns. We use administrative data from the population register on 39,810 Danish births in the years 2007-2010 and complementary survey and municipal administrative data on 8288 births in the years 2007-2009 in a differences-in-differences framework. We show that the strike reduced the number of mothers' prenatal midwife consultations, their length of hospital stay at birth, and the number of home visits by trained nurses after hospital discharge. We find that this reduction in care around birth increased the number of child and mother general practitioner (GP) contacts in the first month. As we do not find strong effects of strike exposure on infant and mother GP contacts in the longer run, this result suggests that parents substitute one type of care for another. While we lack power to identify the effects of care around birth on hospital readmissions and diagnoses, our results for maternal health investments indicate that strike-exposed mothers-especially those who lacked postnatal early home visits-are less likely to exclusively breastfeed their child at four months. Thus reduced care around birth may have persistent effects on treated children through its impact on parental investments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. National Suicide Prevention Lifeline: Enhancing Mental Health Care for Suicidal Individuals and Other People in Crisis

    Science.gov (United States)

    Gould, Madelyn S.; Munfakh, Jimmie L. H.; Kleinman, Marjorie; Lake, Alison M.

    2012-01-01

    Linking at-risk callers to ongoing mental health care is a key goal of crisis hotline interventions that has not often been addressed in evaluations of hotlines' effectiveness. We conducted telephone interviews with 376 suicidal and 278 nonsuicidal crisis callers to the National Suicide Prevention Lifeline (Lifeline) to assess rates of mental…

  3. Symbolic interactionism and nurse-mother communication in the neonatal intensive care unit.

    Science.gov (United States)

    Cleveland, Lisa Marie

    2009-01-01

    The admission of an infant to the neonatal intensive care unit (NICU) has the potential to cause significant stress for the mothers of these infants. Researchers have found that nurse-mother communication has the potential to either aid or hinder the mother's adaptation to the NICU environment. These communication patterns are relatively complex in nature and therefore warrant further investigation. Symbolic interactionism (SI) is a theoretical framework that offers the potential to direct such an investigation. The purpose of this article is to examine nurse-mother communication patterns in the NICU through the theoretical lens of SI.

  4. Video Tells a Mother's Story of Caring Support | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... JavaScript on. Feature: Palliative Care Video Tells a Mother's Story of Caring Support Past Issues / Spring 2014 ... introduced to palliative care, she actually fell in love with her doctor and ran to see him ...

  5. The effect of happiness training on self-esteem in the mothers of children with cleft lip and palate in Isfahan 2015

    OpenAIRE

    Hemati, Zeinab; Derakhshande, Fateme; Abbasi, Samira; Kiani, Davood

    2017-01-01

    BACKGROUND: Birth of a child with cleft lip and palate, as a crisis, can affect family relationships and interactions seriously and hence self-esteem in family members. The present study was conducted to investigate the effect of a happiness training program on self-esteem in the mothers of children with cleft lip and palate. MATERIALS AND METHODS: In this quasi-experimental study, 64 mothers of children with cleft lip and palate referring to health-care team in the Isfahan University Medical...

  6. Child daily care: needs and vulnerabilities from the perspective of adolescent mothers

    Directory of Open Access Journals (Sweden)

    Jaqueline Silva Santos

    2016-12-01

    Full Text Available This study aimed to analyze the care of children from the perspective of adolescent mothers, in order to identify vulnerabilities and needs in the nursing care scope. This is an exploratory research with inductive, qualitative thematic analysis of the data, based on recorded interviews with 20 adolescent mothers of children between six months and under two years old, registered and assisted by Family Health teams of the municipality of Passos, Minas Gerais, Brazil. The maternal reports express aspects about the daily care of the child, attention to their needs, coping with difficulties and recognition of vulnerable situations. Maternal care in adolescence was a unique experience, with maternal reports that point out aspects to be more explored by healthcare professionals, especially by nursing, in search of support offer and enhance maternal trust.

  7. The life-world of mothers who care for mentally retarded children: the Katutura township experience

    Directory of Open Access Journals (Sweden)

    A.M. Ntswane

    2007-09-01

    Full Text Available This article reports on a research study done in Katutura Township, near Windhoek. A qualitative, exploratory, descriptive and contextual design was followed to answer the research question investigating experiences of mothers caring for mentally retarded children at home. Phenomenological interviews were conducted with a purposefully selected sample of twelve mothers. The meaning of their experiences was analysed by using Teschxs method (1990 in Creswell, 1994:155 of analysing qualitative data. The results indicated various emotions and challenges experienced by these mothers during the care of their children. Feelings of shock, despondency and sadness dominated the early stages when the retarded children were still young. During later years, as the children were growing up, the mothers felt shame, fear, frustration, anger, disappointment and worry. However, acceptance followed, as the children grew older. Stigma seemed to affect all the respondents. Support in any form or lack thereof seemed to be the decisive factor-positioning mothers along a continuum of two extremes, namely despairing isolation and integrated happiness. Recommendations were made regarding the improvement of heath care services and education of the mothers and their families.

  8. [Hermeneutic Phenomenological Study on Caring Experience of the Mothers of Children with Epilepsy].

    Science.gov (United States)

    Joung, Woo Joung; Yi, Myungsun

    2017-02-01

    The purpose of this study was to develop a deeper understanding of the experience of mothers caring for children with epilepsy. Data were collected through individual in-depth interviews and observation from 12 mothers of children with epilepsy. Data were collected from December, 2014 to February, 2015 and analyzed using van Manen's hermeneutic phenomenological methodology to identify essential themes of their experience. The essential themes that fit into the context of the 4-existential grounds of time, body, other people, and space were: Lived time-ongoing influence of the past, living in insecure present, fearful future with no answer; Lived body-bonded body, burned out state; Lived other-burden but also support, shrunken down; Lived space-narrowed range of activity, widened horizon. The findings in this study show in-depth understanding of the hardships of mothers who are caring for children with epilepsy. The beauty and greatness of these mothers are revealed through the analysis of various phenomenological materials such as literary and artistic work reflecting socio-cultural context, as well as vivid care experiences of mothers of children with epilepsy. This will be helpful in increasing understanding of the nature of caregivers' experience for medical professionals dealing with patients and caregivers. Also it helps to improve the understanding of the disease among the general public, followed by a more warming and caring attitude towards patients and family members. Finally, it will enhance psychological well-being and overall quality of life of the epileptic children and their families. © 2017 Korean Society of Nursing Science

  9. Home health nursing care services in Greece during an economic crisis.

    Science.gov (United States)

    Adamakidou, T; Kalokerinou-Anagnostopoulou, A

    2017-03-01

    The purpose of this review was to describe public home healthcare nursing services in Greece. The effectiveness and the efficiency of home healthcare nursing are well documented in the international literature. In Greece, during the current financial crisis, the development of home healthcare nursing services is the focus and interest of policymakers and academics because of its contribution to the viability of the healthcare system. A review was conducted of the existing legislation, the printed and electronic bibliography related to the legal framework, the structures that provide home health care, the funding of the services, the human resources and the services provided. The review of the literature revealed the strengths and weaknesses of the existing system of home health care and its opportunities and threats, which are summarized in a SWOT analysis. There is no Greek nursing literature on this topic. The development of home health nursing care requires multidimensional concurrent and combined changes and adjustments that would support and strengthen healthcare professionals in their practices. Academic and nursing professionals should provide guidelines and regulations and develop special competencies for the best nursing practice in home health care. At present, in Greece, which is in an economic crisis and undergoing reforms in public administration, there is an undeniable effort being made to give primary health care the position it deserves within the health system. There is an urgent need at central and academic levels to develop home healthcare services to improve the quality and efficiency of the services provided. © 2016 International Council of Nurses.

  10. Original article The effects of kangaroo mother care in a sample of preterm, preschool aged children

    Directory of Open Access Journals (Sweden)

    Magdalena Chrzan-Dętkoś

    2014-08-01

    Full Text Available Background The research has shown that kangaroo mother care has a protective impact both on health and future cognitive skills of prematurely born babies. The aim of this study was to investigate the relation between the early skin-to-skin contact and the cognitive and emotional-social functioning of preschool aged preterm babies. Participants and procedure The study group included 99 preterm babies. The children participated in a psychological examination conducted using the Columbia Mental Maturity Scale and the Terman-Merrill Test. The data concerning the skin-to-skin contact during the child’s hospitalisation were acquired during interviews with mothers. The emotional development was assessed on the basis of interviews with mothers, conducted using the Rescorla DSM-IV Orientation Scale (2005. Results The study showed no relation between kangaroo mother care and cognitive development. Nevertheless the early skin-to-skin contact turned out to be connected with the emotional functioning of the subjects. Preterm babies who used to experience kangaroo mother care experienced fewer anxiety and depressive disorders than those who did not. In addition it was revealed that the children who suffered from early damage to the brain in the forms of intraventricular and periventricular haemorrhages and experienced kangaroo mother care demonstrated less intense depressive symptoms than those who did not. Conclusions The obtained results, combined with the review of the foreign literature of the subject, indicate the usefulness of introducing kangaroo mother care to neonatal wards and encouraging parents to care about their prematurely born babies in such a way.

  11. Care around birth, infant and mother health and maternal health investments – Evidence from a nurse strike

    DEFF Research Database (Denmark)

    Kronborg, Hanne; Sievertsen, Hans Henrik; Wüst, Miriam

    2016-01-01

    Care around birth may impact child and mother health and parental health investments. We exploit the 2008 national strike among Danish nurses to identify the effects of care around birth on infant and mother health (proxied by health care usage) and maternal investments in the health...... not find strong effects of strike exposure on infant and mother GP contacts in the longer run, this result suggests that parents substitute one type of care for another. While we lack power to identify the effects of care around birth on hospital readmissions and diagnoses, our results for maternal health...... of their newborns. We use administrative data from the population register on 39,810 Danish births in the years 2007–2010 and complementary survey and municipal administrative data on 8288 births in the years 2007–2009 in a differences-in-differences framework. We show that the strike reduced the number of mothers...

  12. Caesarean section deliveries: Experiences of mothers of midwifery care at a public hospital in Nelson Mandela Bay.

    Science.gov (United States)

    Jikijela, Thobeka P; James, Sindiwe; Sonti, Balandeli S I

    2018-01-30

    The rate of caesarean section deliveries has increased globally and mothers are faced with challenges of postoperative recovery and caring thereof. Midwives have a duty to assist these mothers to self-care. The objective was to explore and describe experiences of post-caesarean section delivered mothers of midwifery care at a public hospital in Nelson Mandela Bay. A qualitative, descriptive and explorative research design was used in the study. Data were collected from 11 purposively criterion-selected mothers who had a caesarean section delivery. One-on-one semi-structured interviews were conducted in the post-natal wards. Research ethics, namely autonomy, beneficence, justice and informed consent, were adopted in the study. All participants were informed of their right to withdraw from the study at any stage without penalties. Interviews were analysed using Tesch's method of data analysis. Three main themes were identified as experiences of: diverse pain, physical limitation and frustration and health care services as different. Experiences of mothers following a caesarean section delivery with midwifery services at a public hospital in Nelson Mandela Bay were explored and described as diverse. A need for adequate pain management as well as assistance and breastfeeding support to mothers following caesarean delivery was identified as crucial to promote a good mother-to-child relationship.

  13. Children's Early Child Care and Their Mothers' Later Involvement with Schools

    Science.gov (United States)

    Crosnoe, Robert; Augustine, Jennifer March; Huston, Aletha C.

    2012-01-01

    Theory and policy highlight the role of child care in preparing children for the transition into school. Approaching this issue in a different way, this study investigated whether children's care experiences before this transition promoted their mothers' school involvement after it, with the hypothesized mechanism for this link being the…

  14. Underdevelopment and the health care crisis in Nigeria.

    Science.gov (United States)

    Alubo, S O

    1985-01-01

    It has been said that in all societies but especially in the developing countries, health care is inextricably linked to a nation's political and economic system. Medical underdevelopment is a necessary feature of economic underdevelopment. Health care in Nigeria has traditionally been conceptualized as an autonomous, self-determining phenomenon without links to the wider society; and morbidity and mortality problems explained as internal factors, i.e., inadequate hospitals, clinics, equipment, and materials, and a lack of the necessary personnel. The structural underpinnings of these internal problems are assumed inconsequential and not addressed, and so is the international dimension. This essay goes beyond the modernization paradigm by locating Nigeria's health and sickness problems in the context of underdevelopment, demonstrating how health care is located in the context of Nigeria's political economy. 1st, Nigeria's position within the capitalist world economy is examined along with the structure of power and privileges. Against this background, prevalent morbidity and mortality patterns, and the policies to combat these, are discussed. The current health care crisis, it is argued, must be located within the framework of underdevelopment, and solutions are inseparable from overcoming present structural arrangements.

  15. Economic crisis and nursing in Spain.

    Science.gov (United States)

    Zabalegui, Adelaida; Cabrera, Esther

    2010-07-01

    The purpose of the present study is to describe the economic context in Spain and its impact on the health care sector and in nursing schools. The global economic crisis is affecting nursing in Spain. This study analyses and compares indicators related to health care and nursing schools among European countries. Some new strategies to cope with the challenges arising from the health care crisis are suggested. Health care costs are increasing as a result of the ageing of the Spanish population, immigration, chronicity of health problems and new medical technology. Nursing education has changed in 2010 from a 3-year diploma programme to a 4-year University degree in Nursing. This change requires new resources involving staff, facilities and equipment, all of which are lacking because of the economic crisis in Spain. The worldwide economic crisis has affected Spain more than it has other European Union (EU) countries. This global crisis has an impact on the health care sector as well on nursing schools. It is essential for nursing management to develop creative approaches to maintain cost effective patient care. New programmes and technology must be carefully evaluated in terms of cost effectiveness before being implemented. All health care professionals should be well informed and have a solid understanding of this situation.

  16. Mothers and Fathers Experience Stress of Congenital Heart Disease Differently: Recommendations for Pediatric Critical Care.

    Science.gov (United States)

    Sood, Erica; Karpyn, Allison; Demianczyk, Abigail C; Ryan, Jennie; Delaplane, Emily A; Neely, Trent; Frazier, Aisha H; Kazak, Anne E

    2018-03-10

    To inform pediatric critical care practice by examining how mothers and fathers experience the stress of caring for a young child with congenital heart disease and use hospital and community supports. Qualitative study of mothers and fathers of young children with congenital heart disease. Tertiary care pediatric hospital in the Mid-Atlantic region of the United States. Thirty-four parents (20 mothers, 14 fathers) from diverse backgrounds whose child previously underwent cardiac surgery during infancy. Subjects participated in semi-structured, individual interviews about their experiences and psychosocial needs at the time of congenital heart disease diagnosis, surgical admission, and discharge to home after surgery. Qualitative interview data were coded, and consistent themes related to emotional states, stressors, and supports were identified. Fathers experience and respond to the stressors and demands of congenital heart disease in unique ways. Fathers often described stress from not being able to protect their child from congenital heart disease and the associated surgeries/pain and from difficulties balancing employment with support for their partner and care of their congenital heart disease child in the hospital. Fathers were more likely than mothers to discuss support from the work environment (coworkers/managers, flexible scheduling, helpful distraction) and were less likely to describe the use of hospital-based resources or congenital heart disease peer-to-peer supports. This study highlights the importance of understanding the paternal experience and tailoring interventions to the unique needs of both mothers and fathers. Opportunities for critical care practice change to promote the mental health of mothers and fathers following a diagnosis of congenital heart disease are discussed.

  17. The impact of mentor mother programs on PMTCT service uptake and retention-in-care at primary health care facilities in Nigeria: a prospective cohort study (MoMent Nigeria).

    Science.gov (United States)

    Sam-Agudu, Nadia A; Cornelius, Llewellyn J; Okundaye, Joshua N; Adeyemi, Olusegun A; Isah, Haroun O; Wiwa, Owens M; Adejuyigbe, Ebun; Galadanci, Hadiza; Afe, Abayomi J; Jolaoso, Ibidun; Bassey, Emem; Charurat, Manhattan E

    2014-11-01

    Nigeria is a key target country in the global effort toward elimination of mother-to-child transmission of HIV. Low coverage of prevention of mother-to-child transmission (PMTCT) interventions, adherence, and retention-in-care rates in HIV-positive pregnant women are contributing factors to high mother-to-child transmission of HIV (MTCT) rates. In Nigeria, rural areas, served largely by primary health care facilities, have particularly poor indicators of PMTCT coverage. Mentor Mothers are HIV-positive women who serve as peer counselors for PMTCT clients, provide guidance, and support in keeping appointments and promoting antiretroviral adherence and retention-in-care. The Mother Mentor (MoMent) study aims to investigate the impact of structured Mentor Mother programs on PMTCT outcomes in rural Nigeria. A prospective cohort study will compare rates of retention-in-care among PMTCT clients who are supported by formally-trained supervised Mentor Mothers versus clients who receive standard-of-care, informal peer support. Study sites are 20 primary health care centers (10 intervention, 10 control) in rural North-Central Nigeria. The study population is HIV-positive mothers and exposed infant pairs (MIPs) (N = 480; 240 MIPs per study arm). Primary outcome measures are the proportion of exposed infants receiving early HIV testing by age 2 months, and the proportion of MIPs retained in care at 6 months postpartum. Secondary outcome measures examine antiretroviral adherence, 12-month postpartum MIP retention, and MTCT rates. This article presents details of the study design, the structured Mentor Mother programs, and how their impact on PMTCT outcomes will be assessed.

  18. Care of the infant of the diabetic mother.

    Science.gov (United States)

    Hay, William W

    2012-02-01

    Gestational diabetes mellitus (GDM) from all causes of diabetes is the most common medical complication of pregnancy and is increasing in incidence, particularly as type 2 diabetes continues to increase worldwide. Despite advances in perinatal care, infants of diabetic mothers (IDMs) remain at risk for a multitude of physiologic, metabolic, and congenital complications such as preterm birth, macrosomia, asphyxia, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, polycythemia and hyperviscosity, hypertrophic cardiomyopathy, and congenital anomalies, particularly of the central nervous system. Overt type 1 diabetes around conception produces marked risk of embryopathy (neural tube defects, cardiac defects, caudal regression syndrome), whereas later in gestation, severe and unstable type 1 maternal diabetes carries a higher risk of intrauterine growth restriction, asphyxia, and fetal death. IDMs born to mothers with type 2 diabetes are more commonly obese (macrosomic) with milder conditions of the common problems found in IDMs. IDMs from all causes of GDM also are predisposed to later-life risk of obesity, diabetes, and cardiovascular disease. Care of the IDM neonate needs to focus on ensuring adequate cardiorespiratory adaptation at birth, possible birth injuries, maintenance of normal glucose metabolism, and close observation for polycythemia, hyperbilirubinemia, and feeding intolerance.

  19. The interactions of Canadian ethics consultants with health care managers and governing boards during times of crisis.

    Science.gov (United States)

    Kaposy, Chris; Maddalena, Victor; Brunger, Fern; Pullman, Daryl; Singleton, Richard

    2017-01-01

    Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations. This study investigates the nature and degree of involvement of Canadian ethics consultants in such situations. This qualitative study used semi-structured interviews with Canadian ethics consultants to investigate the nature of their interactions with upper-level managers and governing board members in health care organizations, particularly in times of organizational crisis. We used a purposive sampling technique to identify and recruit ethics consultants throughout Canada. We found variability in the interactions between ethics consultants and upper-level managers and governing boards. Some ethics consultants we interviewed did not participate in managing organizational crisis situations. Most ethics consultants reported that they had assisted in the management of some crises and that their participation was usually initiated by managers. Some ethics consultants reported the ability to bring issues to the attention of upper-level managers and indirectly to their governing boards. The interactions between managers and ethics consultants were characterized by varying degrees of collegiality. Ethics consultants reported participating in or chairing working groups, participating in incident management teams, and developing decision-making frameworks. Canadian ethics consultants tend to believe that they have valuable skills to offer in the management of organizational crisis situations. Most of the ethics consultants

  20. The economic impact of work and family issues: child care satisfaction and financial considerations of employed mothers.

    Science.gov (United States)

    Poms, Laura Wheeler; Botsford, Whitney E; Kaplan, Seth A; Buffardi, Louis C; O'Brien, Alison S

    2009-10-01

    This article introduces the role of financial considerations into work-family research by considering the costs and benefits of employed mothers' child care satisfaction. Data from 2 samples offer empirical support for the addition of a fourth factor to a current measure of child care satisfaction so that the measure reflects mothers' satisfaction not only with caregiver attentiveness, communication, and dependability but also with child care-related financial considerations. This article also discusses relationships between child care satisfaction and work-family conflict and job satisfaction for this population. The results of this study provide both organizations and child care providers with a broader picture of the concerns that employed mothers face as they search for reliable, affordable child care. PsycINFO Database Record (c) 2009 APA, all rights reserved.

  1. Maternal Health Care Practices among Mothers of a Selected Slum in Dhaka City

    Directory of Open Access Journals (Sweden)

    Mohoshina Karim

    2015-09-01

    Full Text Available Background: Bangladesh is a small South Asian country which became independent in 1971 after a bloody war. Rapid urbanisation in Bangladesh (26% of the 147.1 million inhabitants live in urban areas is fuelling a growth in urban poverty, particularly in the urban slums where the quality of life is extremely poor. The average population density in slums was reported in 2005 as 831 persons per acre or 205,415 people per square kilometre.1 Early commencement of antenatal care by pregnant women as well as regular visits has the potential to affect maternal and foetal outcome. Objective: To assess the status of ANC service used by the pregnant mothers and their socio-demographic characteristics. Materials and Methods: A community-based cross-sectional study was conducted at Moghbazar slum area in Dhaka district of Bangladesh, during January to June 2014. A total of 161 slum dwellers were enrolled in the study. Information regarding education, occupation, monthly family income, antenatal care was gathered using a pretested structured questionnnare and data were analysed. Results: The majority respondents had knowledge about antenatal care and of them 89 (55.2% completed ≥3 visits. Forty five (47.8% pregnant women received ANC from government hospitals. Nearly 72% mothers received ANC service from doctors and 16.9% received from family welfare visitors (FWV. Half of mothers were satisfied with the overall care provided to them. About 86.2% mothers said that they had to wait for more than two hours for check-ups. More than 50% received information about exercise and 36% were reassured about discussing fear and anxiety about pregnancy. Conclusion: This study reveals that antenatal care provided was not up to the mark of standard care and measures should be taken to improve it.

  2. The Experience of Decision Making in the Care of Children with Palliative Care Needs: The Experiences of Jordanian Mothers.

    Science.gov (United States)

    Atout, Maha; Hemingway, Pippa; Seymour, Jane

    2017-12-01

    The purpose of this study was to explore the experience of decision making in the care of children with palliative care needs in Jordan, from the perspective of their mothers. This study employed a collective qualitative case study approach. Data were collected in 3 pediatric wards in a Jordanian hospital. The study used 2 data collection methods: participant observation (197 observational hours) and 56 semi-structured interviews with 24 mothers, 12 physicians and 20 nurses. The findings show how Jordanian mothers seek to transfer the role of decision making to physicians, as they perceive themselves to be unable to make decisions about critical issues related to the treatment of their children. Mothers had a widespread apprehension of "future guilt," especially when they feared that any decisions they might make could have an adverse impact on their children. Contrary to the predominant pattern, some mothers took a proactive approach towards decision making about their children's treatment. These mothers requested detailed information from primary physicians and sought different sources of knowledge such as second opinions, reading online resources, or talking to other parents who had a child with similar circumstances. The study concludes that mothers prefer to involve physicians in decisions about their children's healthcare and treatment to eliminate their fear of probable future guilt; this modifies any tendency to autonomously decide for their children. These findings are underpinned by the Jordanian culture in which doctors' opinions are highly regarded.

  3. State Medicaid Expansions for Parents Led to Increased Coverage and Prenatal Care Utilization among Pregnant Mothers.

    Science.gov (United States)

    Wherry, Laura R

    2017-12-28

    To evaluate impacts of state Medicaid expansions for low-income parents on the health insurance coverage, pregnancy intention, and use of prenatal care among mothers who became pregnant. Person-level data for women with a live birth from the 1997-2012 Pregnancy Risk Assessment Monitoring System. The sample was restricted to women who were already parents using information on previous live births and combined with information on state Medicaid policies for low-income parents. I used a measure of expanded generosity of state Medicaid eligibility for low-income parents to estimate changes in health insurance, pregnancy intention, and prenatal care for pregnant mothers associated with Medicaid expansion. I found an increase in prepregnancy health insurance coverage and coverage during pregnancy among pregnant mothers, as well as earlier initiation of prenatal care, associated with the expansions. Among pregnant mothers with less education, I found an increase in the adequacy of prenatal care utilization. Expanded Medicaid coverage for low-income adults has the potential to increase a woman's health insurance coverage prior to pregnancy, as well as her insurance coverage and medical care receipt during pregnancy. © Health Research and Educational Trust.

  4. [Training of health-care employees in crisis resource management].

    Science.gov (United States)

    Spanager, Lene; Østergaard, Doris; Lippert, Anne; Nielsen, Kurt; Dieckmann, Peter

    2013-03-25

    Studies show that human errors contribute to up to 70% of mistakes and mishaps in health care. Crisis resource management, CRM, is a conceptual framework for analysing and training individual and team skills in order to prevent and manage errors. Different CRM training methods, e.g. simulation, are in use and the literature emphasises the need of training the full team or organisation for maximal effect. CRM training has an effect on skill improvement, but few studies have shown an effect on patient outcome. However, these studies show great variability of quality.

  5. Mothers' and fathers' involvement with school-age children's care and academic activities in Navajo Indian families.

    Science.gov (United States)

    Hossain, Ziarat; Anziano, Michael C

    2008-04-01

    This exploratory study examined mothers' and fathers' reports of time involvement in their school-age children's care and academic activities. The study also explored the relationship between parents' socioeconomic status (SES) variables (age, education, income, work hours, and length of marriage) and their relative involvement with children. Mother and father dyads from 34 two-parent Navajo (Diné) Indian families with a second- or third-grade child participated in the study. Repeated measures analysis of variance showed that mothers invested significantly more time in children's care on demand and academic activities than fathers, but the differences in maternal and paternal perceptions of time involvement in routine care were not significant. The gender of the child did not influence the amount of time parents invested in children's care and academic activities. Mothers' involvement with children was not related to any of the SES variables. Fathers' involvement was significantly associated with work hours and length of marriage, and work hours produced significant interaction with fathers' involvement with children. Findings are discussed in light of gender role differences in parental involvement with children within Navajo families.

  6. Effect of residence on mothers' health care seeking behavior for common childhood illness in Northwest Ethiopia: a community based comparative cross--sectional study.

    Science.gov (United States)

    Gelaw, Yalemzewod Assefa; Biks, Gashaw Andargie; Alene, Kefyalew Addis

    2014-10-08

    Children are at higher risk of acquiring infections and developing severe disease. This study assessed the health care seeking behavior and associated factors of urban and rural mothers for common childhood illness in Northwest Ethiopia. A comparative community based cross-sectional study was conducted among urban and rural mothers living in the district. A multistage sampling technique was used to select the study participants. A pre-tested and structured questioner via interview was used to collect the data. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95% CI was computed to assess the strength of the associations. A total of 827 (274 urban and 553 rural) mothers were interviewed. Among these, 79.3% (95% CI: (76.5%, 82.06%)) of the mothers were sought health care in the district. Health care seeking behavior was higher among urban mothers (84.6%) than rural mothers (76.7%). Marital status, completion health extension package, and sex of child were significantly associated with health care seeking behavior of urban mothers. Whereas age of child, age and occupation of mothers, educational level of fathers, wealth quintile, and type of reported illness were significantly associated with rural mothers. Perceived severity of illness was significantly associated with both urban and rural mothers for health care seeking behavior. The overall health seeking behaviors of mothers for common childhood illness was high. However, urban mothers seek health care more than rural. Socio Economic position and types of reported illness has an effect for health seeking behavior of rural mothers. Whereas child sex preference and graduation status for health extension package has an effect for health care seeking behavior of urban mothers. Work on strengthen accessibility of health care services in the rural mothers and increase awareness of mothers about the disadvantage of sex preferences will improve the health care seek behavior of

  7. Defining crisis in families of individuals with autism spectrum disorders

    OpenAIRE

    Weiss, Jonathan A; Wingsiong, Aranda; Lunsky, Yona

    2014-01-01

    Parents of children diagnosed with autism spectrum disorder often report higher levels of depression, anxiety, and mental health–related issues. The combination of stressors and family adjustment difficulties can cause distress which may develop into a crisis. Understanding crisis in the family is important to mental health practice since it can serve as a guide in delivering service to at-risk families. This study investigated the subjective experience of crisis in 155 mothers of children di...

  8. Mothers' knowledge on essential newborn care at Juba Teaching ...

    African Journals Online (AJOL)

    2017-08-03

    Aug 3, 2017 ... Objective: To identify the gaps in the knowledge and practices of essential newborn care among postnatal mothers at Juba. Teaching Hospital .... Baby is kept warm after delivery by: -Skin to skin contact. 128. 33.3. -Wrapping baby in a cloth. 347. 90.4. Duration between birth and first bath: -Hours. 169. 44.1.

  9. Very extensive nonmaternal care predicts mother-infant attachment disorganization: Convergent evidence from two samples.

    Science.gov (United States)

    Hazen, Nancy L; Allen, Sydnye D; Christopher, Caroline Heaton; Umemura, Tomotaka; Jacobvitz, Deborah B

    2015-08-01

    We examined whether a maximum threshold of time spent in nonmaternal care exists, beyond which infants have an increased risk of forming a disorganized infant-mother attachment. The hours per week infants spent in nonmaternal care at 7-8 months were examined as a continuous measure and as a dichotomous threshold (over 40, 50 and 60 hr/week) to predict infant disorganization at 12-15 months. Two different samples (Austin and NICHD) were used to replicate findings and control for critical covariates: mothers' unresolved status and frightening behavior (assessed in the Austin sample, N = 125), quality of nonmaternal caregiving (assessed in the NICHD sample, N = 1,135), and family income and infant temperament (assessed in both samples). Only very extensive hours of nonmaternal care (over 60 hr/week) and mothers' frightening behavior independently predicted attachment disorganization. A polynomial logistic regression performed on the larger NICHD sample indicated that the risk of disorganized attachment exponentially increased after exceeding 60 hr/week. In addition, very extensive hours of nonmaternal care only predicted attachment disorganization after age 6 months (not prior). Findings suggest that during a sensitive period of attachment formation, infants who spend more than 60 hr/week in nonmaternal care may be at an increased risk of forming a disorganized attachment.

  10. CARE SEEKING BEHAVIOUR OF MOTHERS DURING ILLNESS OF NEWBORN IN URBAN SLUMS OF LUCKNOW CITY.

    Directory of Open Access Journals (Sweden)

    P Gupta

    2012-10-01

    Full Text Available Objectives: To study the knowledge of mothers about recognition of danger signs and care seeking behaviour during illness of newborn child in urban slums of Lucknow city, UP. Methods : A cross- sectional study in Urban slums of Lucknow city, UP included 524 women who had a live birth during last one year preceding data collection. The data was tabulated on Microsoft Excel sheet and analyzed using the software SPSS 10.0 for Windows. Results : Study findings showed that Majority (76.9% of the mothers said that if the baby was very cold to touch or running temperature is a danger sign during newborn period followed by absence of sucking (68.9% in previously sucking newborn as danger sign. Majority (71.9% of the mothers consulted local doctor for any problem during neonatal period. Only 12 percent of the mothers approached Govt. doctor for the treatment . It was observed that Hing was given by 86.2 percent mothers in case of stomachache. 82.8 percent mothers had given salt and sugar solutions in the case of diarrhoea\t. Conclusion: In majority of cases correct knowledge and care seeking behaviour during illness of newborn were lacking among mothers and this should be promoted through improved coverage with existing health services.

  11. CARE SEEKING BEHAVIOUR OF MOTHERS DURING ILLNESS OF NEWBORN IN URBAN SLUMS OF LUCKNOW CITY

    Directory of Open Access Journals (Sweden)

    P Gupta

    2012-09-01

    Full Text Available Objectives: To study the knowledge of mothers about recognition of danger signs and care seeking behaviour during illness of newborn child in urban slums of Lucknow city, UP. Methods : A cross- sectional study in Urban slums of Lucknow city, UP included 524 women who had a live birth during last one year preceding data collection. The data was tabulated on Microsoft Excel sheet and analyzed using the software SPSS 10.0 for Windows. Results : Study findings showed that Majority (76.9% of the mothers said that if the baby was very cold to touch or running temperature is a danger sign during newborn period followed by absence of sucking (68.9% in previously sucking newborn as danger sign. Majority (71.9% of the mothers consulted local doctor for any problem during neonatal period. Only 12 percent of the mothers approached Govt. doctor for the treatment . It was observed that Hing was given by 86.2 percent mothers in case of stomachache. 82.8 percent mothers had given salt and sugar solutions in the case of diarrhoea . Conclusion: In majority of cases correct knowledge and care seeking behaviour during illness of newborn were lacking among mothers and this should be promoted through improved coverage with existing health services.

  12. Presentation of the CEA's crisis national organization: coordination centre in case of crisis, crisis technical teams, intervention means, and so on

    International Nuclear Information System (INIS)

    Pectorin, X.

    2010-01-01

    After having briefly recalled the existence of a legal framework for crisis management organisation, this report briefly describes how the CEA plans the crisis management. This management is based on the definition of critical scenarios, on the building up of a crisis management team, and on the elaboration of crisis management operational documents. It evokes the alert organisation and the triggering of crisis management. Then, it describes the CEA's national crisis organisation with its main crisis management structures, the role and the operation of the Crisis Coordination Centre (CCC, the decision body), the role and operation of the Central Crisis Technical Teams (ETC-C, Equipes Techniques de Crise Centrales), the role of field interveners (various rescue, protection, health care and technical teams) and of other additional intervention actors. It evokes the objectives of the various exercises which are organised every year at the internal, national or international level

  13. Mutual Expectations of Mothers of Hospitalized Children and Pediatric Nurses Who Provided Care: Qualitative Study.

    Science.gov (United States)

    Konuk Şener, Dilek; Karaca, Aysel

    This study attempted to identify the mutual expectations of mothers whose children were hospitalized in the pediatric department of a university hospital and nurses who provided care. A descriptive phenomenological design has been used in this study. Data were obtained through tape-recorded semi-structured interviews. This study was conducted at a pediatric clinic, at a university hospital in a small city in Turkey. Participants comprised five nurses working in the children's clinic and 24 mothers who accompanied their children to the hospital. The six major themes that emerged were mothers' feelings and thoughts about the hospital experience, mothers' expectations for attention and support during hospitalization, mothers' expectations for invasive procedures, issues regarding physical comfort and hospital infrastructure, nurses' feelings and thoughts about working in the pediatric clinic, and nurses' expectations of the mothers. Mothers expected nurses to provide physical support including medication administration, and installing/applying IV and nebulizer treatments; and emotional support in terms of having a friendly, rather than critical attitude, and being approachable and receptive of mothers' questions and anxieties. Nurses stated that they were aware of these expectations but needed mothers to be understanding and tolerant, considering their difficult working conditions. Children's hospitalization is a stressful experience for parents. Open and therapeutic communication and relationships between parents and nurses contribute to improving the quality of care provided to children and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. The Ariadne's thread in co-payment, primary health care usage and financial crisis: findings from Cyprus public health care sector.

    Science.gov (United States)

    Petrou, P

    2015-11-01

    Cyprus entered a prolonged financial recession in 2011 and by early 2013 it applied for an international bail-out agreement. This presupposed massive reforms in public governance. Health sector was considerably reformed and one of the measures was the introduction of co-payment for outpatient visits to public health care sector. The scope of this study is to assess the impact of financial crisis and co-payment to public outpatient visits in Nicosia urban and greater Nicosia region. An Interrupted time-series analysis. All outpatient visits to public health care family doctor/general practitioners in Nicosia urban and greater Nicosia region from January 2011 until May of 2014 were registered and analysed. Financial crisis did not alter outpatient visits. Introduction of co-payment led to a statistically significant decrease from the second month after its introduction (p = 0.048) (R(2) = 0.329, Q = 23.75, p = 0.137). This decrease was consistent until the end of the observational period and it did not level off. Financial crisis did not affect outpatient visits while co-payment can be considered as a potent cost containment measure during financial recession, by normalising utilisation of healthcare resources. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. Associations between birth health, maternal employment, and child care arrangement among a community sample of mothers with young children.

    Science.gov (United States)

    Chiao, Chi; Chyu, Laura; Ksobiech, Kate

    2014-01-01

    Although a large body of literature exists on how different types of child care arrangements affect a child's subsequent health and sociocognitive development, little is known about the relationship between birth health and subsequent decisions regarding type of nonparental child care as well as how this relationship might be influenced by maternal employment. This study used data from the Los Angeles Families and Neighborhoods Survey (L.A.FANS). Mothers of 864 children (ages 0-5) provided information regarding birth weight, maternal evaluation of a child's birth health, child's current health, maternal employment, type of child care arrangement chosen, and a variety of socioeconomic variables. Child care options included parental care, relative care, nonrelative care, and daycare center. Multivariate analyses found that birth weight and subjective rating of birth health had similar effects on child care arrangement. After controlling for a child's age and current health condition, multinomial logit analyses found that mothers with children with poorer birth health are more likely to use nonrelative and daycare centers than parental care when compared to mothers with children with better birth health. The magnitude of these relationships diminished when adjusting for maternal employment. Working mothers were significantly more likely to use nonparental child care than nonemployed mothers. Results suggest that a child's health early in life is significantly but indirectly related to subsequent decisions regarding child care arrangements, and this association is influenced by maternal employment. Development of social policy aimed at improving child care service should take maternal and family backgrounds into consideration.

  16. Selfish mothers? An empirical test of parent-offspring conflict over extended parental care.

    Science.gov (United States)

    Paul, Manabi; Sen Majumder, Sreejani; Bhadra, Anindita

    2014-03-01

    Parent-offspring conflict (POC) theory is an interesting conceptual framework for understanding the dynamics of parental care. However, this theory is not easy to test empirically, as exact measures of parental investment in an experimental set-up are difficult to obtain. We have used free-ranging dogs Canis familiaris in India, to study POC in the context of extended parental care. We observed females and their pups in their natural habitat for the mother's tendency to share food given by humans with her pups in the weaning and post-weaning stages. Since these dogs are scavengers, and depend largely on human provided food for their sustenance, voluntary sharing of food by the mother with her pups is a good surrogate for extended parental care. Our behavioural observations convincingly demonstrate an increase of conflict and decrease of cooperation by the mother with her offspring over given food within a span of 4-6 weeks. We also demonstrate that the competition among the pups in a litter scales with litter size, an indicator of sib-sib competition. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Timing and factors associated with first antenatal care booking among pregnant mothers in Gondar Town; North West Ethiopia.

    Science.gov (United States)

    Gudayu, Temesgen Worku; Woldeyohannes, Solomon Meseret; Abdo, Abdella Amano

    2014-08-25

    Antenatal care service which is among strategies to maintain maternal and fetal wellbeing is strongly recommended to be initiated early during pregnancy. To developing world where there is uncommon practice of pre-pregnancy care and support, timely commencement is crucial in getting potential benefits from some of the elements of the care. Therefore, we sought to assess timing and factors associated with the first antenatal care booking among pregnant mothers attending antenatal care clinics in Gondar town health facilities; North West Ethiopia. Health institution based cross-sectional study was conducted among pregnant mothers from April to June 2012 in Gondar town. A total of 407 pregnant mothers were interviewed at exit from antenatal clinic by using structured and pre-tested questionnaire. Bivariate and multivariate data analysis was performed using SPSS for Windows version 16.0. The study indicated that 35.4% of mothers started antenatal care timely (in the first trimester of pregnancy). The mean time was 4.5 months (17.7 weeks) of pregnancy. Multivariate logistic regression analysis showed that: [(AOR (95% CI)) maternal age ≤ 25 (1.85 (1.10, 3.09)), age at marriage ≥20 years (2.21 (1.33, 3.68)), pregnancy recognition by urine test (2.29 (1.42, 3.71)), mothers who perceived the right time to start antenatal care within first trimester (3.93 (2.29, 6.75)) and having decision power to use antenatal care (2.43 (1.18, 4.99))] were significantly associated with timely commencement to antenatal care. Timely entry to antenatal care was low in the study area. In order to improve the situation, it is important to provide community based information, education and communication on antenatal care and its right time of commencement. In addition, empowering women and implementing the proclamation designed for the age at marriage is mandatory up to the local level.

  18. Health seeking behavior of the mothers for the special care new-born unit discharged children: a comparative study.

    Science.gov (United States)

    Jeet, Gursimer; Sharma, Atul; Mohanta, Tulika Goswami; Trakroo, Ajay

    2013-01-01

    Establishment of special care new-born units (SCNU) in hospitals not only serves to provide the intensive care to sick neonates, but presents with opportunities to enhance knowledge and modify attitude and practices of their parents through behavior change communication (BCC). A cross-sectional study was conducted in Dibrugarh District, Assam from January to June, 2011 to assess differences in health-care seeking behavior of these mothers from mothers of newborns who were born at home and mothers who had normal uneventful institutional deliveries. Mothers of 29 SCNU discharged, 34 institutions delivered and 26 home delivered children were interviewed using a semi-structured interview schedule and a knowledge, attitude and practice (KAP) survey tool. Mothers of children admitted to SCNU scored better in questions related to vaccination, contraception, protection of child from infections and cold and perceptions about traditional healers, but overall KAP scores in the three groups were not found significantly different.

  19. Suicide Attempts and Completions among Mothers Whose Children Were Taken into Care by Child Protection Services: A Cohort Study Using Linkable Administrative Data.

    Science.gov (United States)

    Wall-Wieler, Elizabeth; Roos, Leslie L; Brownell, Marni; Nickel, Nathan; Chateau, Dan; Singal, Deepa

    2018-03-01

    The objective of this study is to examine suicide attempts and completions among mothers who had a child taken into care by child protection services (CPS). These mothers were compared with their biological sisters who did not have a child taken into care and with mothers who received services from CPS but did not have a child taken into care. A retrospective cohort of mothers whose first child was born in Manitoba, Canada, between April 1, 1992, and March 31, 2015, is used. Rates among discordant biological sisters (1872 families) were compared using fixed-effects Poisson regression models, and mothers involved with CPS (children in care [ n = 1872] and received services [ n = 9590]) were compared using a Poisson regression model. Compared with their biological sisters and mothers who received services, the adjusted incidence rate ratio (aIRR) of death by suicide was greater among mothers whose child was taken into care by CPS (aIRR = 4.46 [95% confidence interval (CI), 1.39-14.33] and ARR = 3.45 [95% CI, 1.61-7.40], respectively). Incidence rates of suicide attempts were higher among mothers with a child taken into care compared with their sisters (aIRR = 2.15; 95% CI, 1.40-3.30) and mothers receiving services (aIRR = 2.82; 95% CI, 2.03-3.92). Mothers who had a child taken into care had significantly higher rates of suicide attempts and completions. When children are taken into care, physician and social workers should inquire about maternal suicidal behaviour and provide appropriate mental health.

  20. Maternal Employment, Nonparental Care, Mother-Child Interactions, and Child Outcomes during Preschool Years

    Science.gov (United States)

    Nomaguchi, Kei M.

    2006-01-01

    This study examines the relationships between maternal employment, nonparental care, mother-child interactions, and preschoolers' outcomes. Data from the Canadian National Longitudinal Survey of Children and Youth (N = 1,248) show that maternal employment during the previous year, especially full-time employment, was related to care by…

  1. The relationship between out-of-home care and the quality of infant-mother attachment in an economically disadvantaged population.

    Science.gov (United States)

    Vaughn, B E; Gove, F L; Egeland, B

    1980-12-01

    The effects of routine daily separations occasioned by out-of-home care on the formation and maintenance of infant-mother attachment relationships were examined in a population of economically disadvantaged mothers. 3 groups were constituted on the basis of the time in the infant's life when out-of-home care began: (1) before 12 months; (2) between 12 and 18 months; (3) home-care controls. The infant-mother pairs were observed in the Ainsworth strange situation at both 12 and 18 months, and were classified as secure, anxious-avoidant, or anxious-resistant. Because previous research has implicated the psychological accessibility of the mother to the infant in the development of anxious-avoidant attachments during the first year of life, the hypothesis that physical inaccessibility due to out-of-home care would also be associated with anxious-avoidant attachments was tested. The data support this hypothesis. At 12 months 47% of the infants whose mothers had returned to work/school were classified in the anxious-avoidant group, while the other 2 groups did not differ significantly in the proportions of infants assigned to the 3 attachment classifications. At 18 months, differences among the 3 work status groups also showed a large portion of anxious-avoidant infants (41%) in this early working group. However, infants whose out-of-home care began after 12 months did not show an increase in the proportion of anxious attachments. Additional analyses of variables related to mother's return to work indicated that single mothers were more likely to return to work/school, that mothers who worked reported higher levels of life stress than mothers who stayed home with the infants, and that, by 18 months, both anxious-avoidant and anxious-resistant attachments were also associated with non-intact families.

  2. Bias in employment decisions about mothers and fathers: The (dis)advantages of sharing care responsibilities

    NARCIS (Netherlands)

    Vinkenburg, C.J.; Van Engen, M.L.; Coffeng, J.; Dikkers, J.S.E.

    2012-01-01

    Bias against mothers in employment decisions has often been explained by the assumption that mothers are less committed and competent than fathers and nonparents. In a simulated employment context, we studied whether this "motherhood bias" can be attenuated by different ways of dividing care

  3. Low-income Euro-American mothers' perceptions of health and self-care practices.

    Science.gov (United States)

    Mendias, Elnora P; Clark, Michele C; Guevara, Edilma B; Svrcek, Claire Y

    2011-01-01

    Health promotion activities may decrease preventable diseases and health system overuse. This study examined how low-income Euro-American mothers described their health/wellness, self-care practices (SCP), and SCP benefits, barriers, and interpersonal influences (norms, modeling, and social support) affecting their SCP. This descriptive qualitative study used a convenience sample of 10 low-income, English-speaking mothers, 25-43 years old, seeking women's/children's health services at a large urban Texas health clinic. Data were collected via face-to-face interviews, using a standardized semistructured interview guide; data were analyzed using Miles and Huberman's qualitative research methods. All participants primarily described themselves positively and as mothers and workers. Most viewed health and wellness as distinct but typically included physical and emotional well-being. Mothers valued health and SCP for personal and family reasons. All identified SCP benefits. Most identified SCP barriers. Women viewed themselves as vital to family function and well-being, learned SCP primarily from parents during childhood, and described limited support for SCP. The results provide a better understanding of participants' self-care decision making and are useful in designing appropriate clinical health promotions. Reducing health inequities in low-income women requires further study of the underlying causes and development of effective policies and measures to address them. © 2011 Wiley Periodicals, Inc.

  4. Disposition and Health Outcomes among Infants Born to Mothers with No Prenatal Care

    Science.gov (United States)

    Friedman, Susan Hatters; Heneghan, Amy; Rosenthal, Miriam

    2009-01-01

    Objective: This study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity). Methods: A retrospective record…

  5. Ethnic variations in pathways to acute care and compulsory detention for women experiencing a mental health crisis.

    Science.gov (United States)

    Lawlor, Caroline; Johnson, Sonia; Cole, Laura; Howard, Louise M

    2012-01-01

    Much recent debate on excess rates of compulsory detention and coercive routes to care has focused on young black men; evidence is less clear regarding ethnic variations among women and factors that may mediate these. To explore ethnic variations in compulsory detentions of women, and to explore the potential role of immediate pathways to admission and clinician-rated reasons for admission as mediators of these differences. All women admitted to an acute psychiatric inpatient ward or a women's crisis house in four London boroughs during a 12-week period were included. Data were collected regarding their pathways to care, clinician-rated reasons for admission, hospital stays, and social and clinical characteristics. Two hundred and eighty seven (287) women from white British, white other, black Caribbean, black African and black other groups were included. Adjusting for social and clinical characteristics, all groups of black patients and white other patients were significantly more likely to have been compulsorily admitted than white British patients; white British patients were more likely than other groups to be admitted to a crisis house and more likely than all the black groups to be admitted because of perceived suicide risk. Immediate pathways to care differed: white other, black African and black other groups were less likely to have referred themselves in a crisis and more likely to have been in contact with the police. When adjustment was made for differences in pathways to care, the ethnic differences in compulsory admission were considerably reduced. There are marked ethnic inequities not only between white British and black women, but also between white British and white other women in experiences of acute admission. Differences between groups in help-seeking behaviours in a crisis may contribute to explaining differences in rates of compulsory admission.

  6. Making Work Fit Care: Reconciliation Strategies Used by Working Mothers of Adults with Intellectual Disabilities

    Science.gov (United States)

    Chou, Yueh-Ching; Fu, Li-yeh; Chang, Heng-Hao

    2013-01-01

    Background: This study explored the experiences of working mothers with an adult child with intellectual disabilities to understand how they reconcile paid work and care responsibilities. Methods: Fifteen working mothers in Taiwan with an adult child with intellectual disabilities were interviewed, and an interpretative phenomenological approach…

  7. [Effects of a Mobile Web-based Pregnancy Health Care Educational Program for Mothers at an Advanced Maternal Age].

    Science.gov (United States)

    Wang, Hee Jung; Kim, Il Ok

    2015-06-01

    This study was conducted to develop a mobile web-based pregnancy health care educational program for mothers who were at an advanced maternal age (AMA) and to verify the effects of the program on pregnancy health care. This program was developed using a web-based teaching-learning system design model and composed of 10 subject areas. This research was a quasi-experimental study using a non-equivalent control group pretest-posttest time serial design and data were collected from April 2 to May 3, 2014. To verify the effects of the program, it was used for 2 weeks with 30 AMA mothers (experimental group). For the control group, a classroom education booklet for pregnant women used with 31 AMA mothers. The experimental group having participated in program had statistically significantly higher scores for knowledge (t=3.76, pcare, compared to the control group. The results of the program indicate that a Mobile web-based pregnancy health care educational program is effective in meeting the needs of AMA mothers and can be used as the prenatal educational program for AMA mothers and is appropriate as an educational media for theses mothers.

  8. Practices of traditional birth attendants in Sierra Leone and perceptions by mothers and health professionals familiar with their care.

    Science.gov (United States)

    Dorwie, Florence M; Pacquiao, Dula F

    2014-01-01

    Describe practices of traditional birth attendants (TBAs) in assisting women in childbirth and the perceptions of TBAs by mothers and health professionals familiar with their work. Qualitative design using focus groups conducted in urban and rural settings in Sierra Leone. Separate audiotaped focus groups conducted for each group of participants lasting between 45 and 90 minutes. Purposive sample of 20 TBAs, 20 mothers, and 10 health professionals who met the following criteria: (a) at least 18 years of age, (b) TBAs currently practicing, (c) mothers who delivered at least one child assisted by a TBA, and (d) health professionals currently practicing in the hospital and familiar with TBA practices. TBAs are valued by mothers, health professionals, and the community because they provide accessible and affordable care to mothers who may otherwise have no access to health services. TBAs need training, supervision, and resources for effective referral of mothers. Systemic problems in the health care system create enormous barriers to effective care for mothers and children independent of TBA practices that contribute to high maternal and infant mortality rates. The study findings have implications on broad public policy in improving maternal and child health in the country.

  9. Perceptions of mothers and hospital staff of paediatric care in 13 public hospitals in northern Tanzania

    DEFF Research Database (Denmark)

    Mwangi, Rose; Chandler, Clare; Nasuwa, Fortunata

    2008-01-01

    User and provider perceptions of quality of care are likely to affect both use and provision of services. However, little is known about how health workers and mothers perceive the delivery of care in hospital paediatric wards in Africa. Paediatric staff and mothers of paediatric inpatients were...... interviewed to explore their opinions and experience of the admission process and conditions on the ward. Overcrowding, unsanitary conditions and lack of food were major concerns for mothers on the ward, who were deterred from seeking treatment earlier due to fears that hospital admission posed a significant...... risk of exposure to infection. While most staff were seen as being sympathetic and supportive to mothers, a minority were reported to be judgemental and authoritarian. Health workers identified lack of trained staff, overwork and low pay as major concerns. Staff shortages, lack of effective training...

  10. Labor Supply Heterogeneity and Demand for Child Care of Mothers with Young Children

    NARCIS (Netherlands)

    Apps, Patricia F.; Kabátek, J.; Rees, Ray; van Soest, A.H.O.

    2012-01-01

    This paper introduces a static structural model of hours of market labor supply, time spent on child care and other domestic work, and bought in child care for married or cohabiting mothers with pre-school age children. The father's behavior is taken as given. The main goal is to analyze the

  11. [The meanings constructed in the attention to a crisis in the territory: the psychosocial care center as a protagonist].

    Science.gov (United States)

    Willrich, Janaína Quinzen; Kantorski, Luciane Prado; Chiavagatti, Fabieli Gopinger; Cortes, Jandro Moraes; Antonacci, Milena Hohmann

    2013-06-01

    The attention to a crisis is a strategic point in the process of paradigm changes proposed by the Brazilian psychiatric reform, requiring changes in alternative services and in the professionals that must use new technologies of care. This study aimed to identify the actions of attention to a crisis in the territory and the meanings as they evolved, beginning from the discursive practices of the professionals. It was a qualitative study that used the theoretical perspective of social constructionism. From the database of the research, Evaluation of the Psychosocial Care Centers in Southern Brazil (CAPSUL), 27 interviews were analyzed from the professionals of Psychosocial Care Center for Alegrete, along with field diaries with 390 hours of observation. Results showed patient engagement/welcoming and accountability for care. We concluded that freedom, reciprocity, contractuality and responsibility for care were the new meanings needed for the alternative care services to overcome the asylum and sense of exclusion and dangerousness.

  12. OBSERVATION ON INCREASE IN WEIGHT OF LOW BIRTH WEIGHT (LBW) BABIES BY IMPLEMENTING KANGAROO MOTHER CARE (KMC) TECHNIQUE

    OpenAIRE

    Purnendu Kumar Singh; Kumar Amritanshu; Bijoy Mukherjee

    2014-01-01

    Kangaroo Mother Care (KMC) is a practical technique for nursing of low birth weight babies by direct skin to contact with the mother. This study was undertaken to observe and record the effect of KMC with focus on increase in weight of at term low birth weight (LBW) babies weighing less than 2000 grams. The study was conducted over thirty six month’s period from July 2011 to June 2014. The method of care consisted of skin to skin contact between the mother and the infant along ...

  13. "Pastoral crisis intervention": toward a definition.

    Science.gov (United States)

    Everly, G S

    2000-01-01

    The pastoral community represents a large and often untapped resource in times of crisis. It possesses a unique aggregation of characteristics that makes it uniquely valuable amidst the turmoil of a psychological crisis. In critical incidents such as terrorism, mass disasters, violence, the loss of loved ones, and any events wherein human actions result in injury, destruction, and/or death, the pastoral community may possess especially powerful restorative attributes. Unfortunately, heretofore, there has existed no generally recognized and accepted manner in which the healing factors inherent in pastoral care have been functionally integrated with the well-formulated principles of crisis intervention. This paper represents an initial effort to elucidate how the principles of pastoral care may be functionally integrated with those of crisis intervention. The amalgam shall heretofore be referred to as "pastoral crisis intervention" and is defined herein.

  14. Mãe adolescente cuidando do filho Adolescent mother caring for their child

    Directory of Open Access Journals (Sweden)

    Regina Matos

    2000-12-01

    Full Text Available Trata-se de uma pesquisa qualitativa, que teve como objetivo conhecer a percepção das mães adolescentes sobre o cuidar do filho. Como trajetória metodológica, utilizamos da fenomenologia, que como um caminho, um movimento, permitiu-nos apreender a essência do fenômeno a partir dos significados emergidos dos discursos de 7 (sete sujeitos que participaram da pesquisa. Para as adolescentes cuidar do filho significa: alimentar a criança, fazer a higiene, tratar a doença, promover o sono, dar atenção, dar carinho, promover a recreação e a educação. Estes temas de análise convergiram para 3 (três categorias abertas: atender as necessidades biológicas da criança, atender as necessidades psíquicas da criança e atender as necessidades sociais da criança.This is a qualitative research that had the objective of understanding the perception of adolescent mothers about their child Os care. The phenomenological approach was used to analyze data gathered from 7 mothers. To the adolescent mothers caring for their child means feeding the child, do his/her hygiene, care for his/her illness, promote rest, give attention, give love, give educational support and promote leisure. These themes converge to 3 main cathegories: attend to the biological, psychological and social necessities of the child.

  15. Integrating the teaching-learning process of Occupational Therapy students and the care of mothers of babies at risk during hospitalization

    Directory of Open Access Journals (Sweden)

    Regina Helena Vitale Torkomian Joaquim

    2016-03-01

    Full Text Available Introduction: This study approaches the process of teaching-learning of a group of occupational therapy students to act in the care of mothers of babies at risk in the hospital context. It is linked to a community project, supported by the ‘Programa de Extensao Universitaria’. Objective: It aimed to qualify the students for understanding the risk rising, the initial mother-baby bond in the hospital environment, the monitoring of the child development and troubleshooting, as well as to see themselves as subjects of their own training. Method: Participants were six students, three teachers, 26 mothers and their 28 babies. The procedures had been developed in three articulated axles: practice, theoretical basis and invitation to reflection, each axle guided by one of three teachers. There were 65 meetings; 27 of the group of mothers, 11 of the group for theoretical overviews and 27 of the reflection group. Six students have completed their participation in the study, having achieved qualification for the care of occupational therapy to mothers of babies at risk during hospitalization and at home after discharge, as well as the co-responsibility with people and served family. All 26 mothers received care in the nursery; 25 of them in addition to the nursery, were treated at mothers group and 6 in addition to the nursery and the group, were visited at home. Conclusion: This study made it possible to contemplate two subjects with the same priority: the mother and her baby, as subjects of the attention and care of an occupational therapist and the student, as the subject of the attention and care of the teacher of occupational therapy.

  16. Mothers' part-time employment: associations with mother and family well-being.

    Science.gov (United States)

    Buehler, Cheryl; O'Brien, Marion

    2011-12-01

    The associations between mothers' part-time employment and mother well-being, parenting, and family functioning were examined using seven waves of the NICHD Study of Early Child Care and Youth Development data (N = 1,364), infancy through middle childhood. Concurrent comparisons were made between families in which mothers were employed part time and both those in which mothers were not employed and those in which mothers were employed full time. Using multivariate analysis of covariance with extensive controls, results indicated that mothers employed part time had fewer depressive symptoms during the infancy and preschool years and better self-reported health at most time points than did nonemployed mothers. Across the time span studied, mothers working part time tended to report less conflict between work and family than those working full time. During their children's preschool years, mothers employed part time exhibited more sensitive parenting than did other mothers, and at school age were more involved in school and provided more learning opportunities than mothers employed full time. Mothers employed part time reported doing a higher proportion of child care and housework than mothers employed full time. Part-time employment appears to have some benefits for mothers and families throughout the child rearing years.

  17. Security giving in surrogacy motherhood process as a caring model for commissioning mothers: A theory synthesis.

    Science.gov (United States)

    Zandi, Mitra; Vanaki, Zohreh; Shiva, Marziyeh; Mohammadi, Eesa; Bagheri-Lankarani, Narges

    2016-07-01

    Despite the increasing use of surrogacy, there are no caring theories/models that serve as the basis for nursing care to surrogacy commissioning mothers. This study has designed a model for caring of surrogacy commissioning mothers in 2013. The theory synthesis of Walker and Avant's strategies of theory construction (2011) was used to design a caring model/theory. The theory synthesis includes three stages: (i) selection of focal concept (the concept of "security giving in motherhood" was selected); (ii) review of studies in order to identify factors related to focal concept relevant studies (42 articles and 13 books) were reviewed, statements and concepts related to focal concept were then extracted and classified, and their relations were specified; and (iii) organization of concepts and statements within a relevant general and effective manifestation of the phenomenon under study which led to developing of a model. In this caring model/theory, entitled "security giving in surrogacy motherhood", nurses roles were conceptualized within the conceptual framework that includes three main roles: (i) coordination; (ii) participation; and (iii) security giving (physical, emotional, and legal support; empowerment; presence; relationship management between both parties and advocacy). Training surrogacy specialist nurses and establishment of surrogacy care centers are important factors for implementation of the model. This model could help to provided better caring for surrogacy clients, especially for commissioning mothers. © 2016 Japan Academy of Nursing Science.

  18. Health seeking behavior of the mothers for the special care new-born unit discharged children: A comparative study

    OpenAIRE

    Gursimer Jeet; Atul Sharma; Tulika Goswami Mohanta; Ajay Trakroo

    2013-01-01

    Establishment of special care new-born units (SCNU) in hospitals not only serves to provide the intensive care to sick neonates, but presents with opportunities to enhance knowledge and modify attitude and practices of their parents through behavior change communication (BCC). A cross-sectional study was conducted in Dibrugarh District, Assam from January to June, 2011 to assess differences in health-care seeking behavior of these mothers from mothers of newborns who were born at home and mot...

  19. Health care and social service professionals' perceptions of a home-visit program for young, first-time mothers.

    Science.gov (United States)

    Li, S A; Jack, S M; Gonzalez, A; Duku, E; MacMillan, H L

    2015-01-01

    Little is known about health care and social service professionals' perspective on the acceptability of long-term home-visit programs serving low-income, first-time mothers. This study describes the experiences and perspectives of these community care providers involved with program referrals or service delivery to mothers who participated in the Nurse-Family Partnership (NFP), a targeted nurse home-visit program. The study included two phases. Phase I was a secondary qualitative data analysis used to analyze a purposeful sample of 24 individual interviews of community care providers. This was part of a larger case study examining adaptations required to increase acceptability of the NFP in Hamilton, Ontario, Canada. In Phase II (n = 4), themes identified from Phase I were further explored through individual, semi-structured interviews with community health care and social service providers, giving qualitative description. Overall, the NFP was viewed as addressing an important service gap for first-time mothers. Providers suggested that frequent communication between the NFP and community agencies serving these mothers could help improve the referral process, avoid service duplication, and streamline the flow of service access. The findings can help determine key components required to enhance the success of integrating a home-visit program into an existing network of community services. The function of home-visit programs should not be viewed in isolation. Rather, their potential can be maximized when they collaborate and share information with other agencies to provide better services for first-time mothers.

  20. Psychosocial Needs and Facilitators of Mothers Caring for Children with Duchenne/Becker Muscular Dystrophy.

    Science.gov (United States)

    Peay, Holly L; Meiser, Bettina; Kinnett, Kathleen; Tibben, Aad

    2018-02-01

    Care guidelines for Duchenne/Becker muscular dystrophy (DBMD) include recommendations for assessment of caregivers of patients with DBMD followed by proactive psychosocial interventions. To inform clinical assessment, this study described appraisals of psychosocial needs and caregiving facilitators of mothers of individuals with DBMD. Two hundred and five mothers completed an online survey. More than 50% endorsed unmet needs for managing uncertainty about the future and managing DBMD fears. Higher levels of unmet need were associated with less disease progression/earlier stage of DBMD (rho = -0.166 p = 0.02). Twenty-one percent regularly used respite care and 57% worried about allowing others to care for their child. Highly-endorsed care facilitators included partner relationships (63%), child's approach to life (59%), and family relationships (49%). Our findings highlight the importance of psychological and social support for caregivers. Starting when children are young, clinicians should assess caregivers' unmet psychological needs, particularly uncertainty and fear. Exploring needs and facilitators may allow clinics to target and customize interventions that build upon existing strengths and supports. Our findings have implications for efforts to promote early diagnosis and newborn screening, in that increased needs in mothers of younger children should be anticipated and built into counseling. Further research can assess whether and how unmet needs change as new therapies become available.

  1. Predictors of early postpartum mental distress in mothers with midwifery home care--results from a nested case-control study.

    Science.gov (United States)

    Staehelin, Katharina; Kurth, Elisabeth; Schindler, Christian; Schmid, Monika; Zemp Stutz, Elisabeth

    2013-08-27

    The prevalence of early postpartum mental health conditions is high. Midwives and other health professionals visiting women at home may identify mothers at risk. This seems crucial given decreasing trends of length of hospital stay after childbirth. This study aimed to identify predictors of maternal mental distress in a midwifery home care setting. Using the statistical database of independent midwives' services in Switzerland in 2007, we conducted a matched nested case-control study. Out of a source population of 34,295 mothers with midwifery home care in the first ten days after childbirth, 935 mothers with maternal distress and 3,645 controls, matched by midwife, were included. We analysed whether socio-demographic, maternal and neonatal factors predict maternal mental distress by multivariable conditional logistic regression analysis. Infant crying problems and not living with a partner were the strongest predictors for maternal distress, whereas higher parity was the most protective factor. Significantly elevated risks were also found for older age, lower educational levels, breast/breastfeeding problems, infant weight gain concerns, neonatal pathologies and use of midwifery care during pregnancy. A lower likelihood for maternal distress was seen for non-Swiss nationality, full-time employment before birth, intention to return to work after birth and midwife-led birth. The study informs on predictors of maternal mental distress identified in a home care setting in the early postpartum period. Midwives and other health care professionals should pay particular attention to mothers of excessively crying infants, single mothers and primipara, and assess the need for support of these mothers.

  2. Evaluating the Effect of Mother – Baby Skin- to- Skin Care on Neonatal Outcomes in Preterm Infants

    Directory of Open Access Journals (Sweden)

    M Kalhor

    2016-08-01

    Full Text Available Introduction: Involving the parents in caring of premature newborns is one of the best and effective manners for preventing the hospitalization of premature newborns. The present study aimed to evaluate the effect of mother – baby skin- to- skin care on neonatal outcomes in preterm infants, in Kosar hospital. Methods: This was a descriptive comparative study conducted on 400 nulliparous women with premature infants admitted to neonatal intensive care unit of Kosar hospital during April 2012 and March 2015. Sampling was performed via convenience sampling. Sample population divided into two groups, one of them 200, the kangaroo care and non- care groups. The data were obtained by a researcher prepared check list, including mother’s demographic characteristics and neonatal outcomes. Both descriptive and statistical analysis methods were applied. For analyzing the data, chi-square test, t-test, and logistic regression tests was applied (P 0.05. In the intervention group, the relationship between maternal variables and neonatal outcome was significant (P <0.05. Conclusion: Mother – baby skin- to- skin care has a positive effect on neonatal outcomes. Thus, supporting and awareness of premature infants’ mothers in order to implement this type of care can reduce the neonatal complications. Moreover, it is effective in decreasing the treatment costs.

  3. Maternal perceptions of family-centred support and their associations with the mother-nurse relationship in the neonatal intensive care unit.

    Science.gov (United States)

    Shimizu, Aya; Mori, Akiko

    2018-04-01

    To evaluate maternal perceptions of family-centred support with hospitalised preterm infants and their relationship between mothers and nurses in the neonatal intensive care unit (NICU). Mothers who gave birth to preterm infants tend to suffer more stress and need individual support based on family-centred care. However, there may be a shortage of support for mothers to obtain parent-crafting skills before bringing their infants home. This cross-sectional study used path analysis and multiple group analysis to evaluate a structural equation model of the relationship between maternal perception based on family-centred support in parent-crafting training and the mothers-nurses collaboration. We analysed data from 98 mothers (valid response proportion, 41.0%) whose infants were hospitalised in the NICU of two types of perinatal centres in Japan. We used three revised standardised questionnaires in Japanese: Measure of Process of Care in the NICU (Neo-MPOC 20), Enabling Practice Scale in the NICU (Neo-EPS) and the author-developed Mother and Infant Questionnaire. Path analysis revealed that the relationship between mothers and nurses was linked to three factors related to the perinatal centres' support: consideration of parents' feelings, ability to deal with specific needs and coordination in dealing with situations that interact with provision of parent-friendly visual information. Separate path analyses for each perinatal centre showed the same pattern, although the standard coefficients were different. Maternal perceptions of family-centred support with hospitalised preterm infants promoted better collaboration between mothers and nurses to obtain parent-crafting skills at two types of perinatal units in Japan. Clear visual information materials might promote better maternal understanding of their infants, help in acquisition of parent-crafting skills and improve mother-nurse collaboration, with the result that mothers are better able to care for their infants

  4. Access to health care for children with neural tube defects: Experiences of mothers in Zambia

    Directory of Open Access Journals (Sweden)

    Micah M. Simpamba

    2016-12-01

    Full Text Available Introduction: In Zambia, all children born with neural tube defects requiring surgery need to be referred to a tertiary level hospital in Lusaka, the capital city, where the specialists are based. The aim of this study was to explore the experiences of mothers accessing health care who had recently given birth to a child with a neural tube defect. Methods and analysis: In-depth interviews were conducted with a purposively selected sample of 20 mothers at the tertiary level hospital. The interviews were audiotaped, transcribed verbatim and translated. Content analysis was used to identify codes, which were later collapsed into categories and themes. Findings: Five themes emerged: access to health care, access to transport, access to information, concerns about family and support needs. Discussion: Barriers to access to health care included geographical barriers and barriers linked to availability. Geographical barriers were related to distance between home and the health centre, and referral between health facilities. Barriers to availability included the lack of specialist health workers at various levels, and insufficient hospital vehicles to transport mothers and children to the tertiary level hospital. The main barrier to affordability was the cost of transport, which was alleviated by either family or government support. Acceptability of the health services was affected by a lack of information, incorrect advice, the attitude of health workers and the beliefs of the family. Conclusion: Access to health care by mothers of children with neural tube defects in Zambia is affected by geographical accessibility, availability, affordability and acceptability. The supply-side barriers and demand-side barriers require different interventions to address them. This suggests that health policy is needed which ensures access to surgery and follow-up care.

  5. Mothers' experience of caring for a child with early onset scoliosis: A qualitative descriptive study.

    Science.gov (United States)

    Lauder, Bonnie; Sinclair, Peter M; Maguire, Jane

    2018-04-01

    This study aimed to identify and describe the experience of parents of children diagnosed with early onset scoliosis living in Australia. Chronic childhood disease has a major impact on health-related quality of life. Caring for a child with a chronic illness is well documented but the specific experiences of parents who care for children with early onset scoliosis, a rare but devastating illness, has not been explored. Numerous studies have described the interrelated psychological, financial, social, physical and logistical factors that impact the experience of the caregiver role with various diseases, but in the case of early onset scoliosis, limited studies have been conducted about the parental experience. A qualitative descriptive design was used. A snowball sampling technique assisted in the recruitment. Parents invited to the study included mothers, fathers and guardians. Data were collected through semistructured interviews and transcribed verbatim. Transcripts were analysed thematically. Data collection complied with the Consolidated criteria for reporting qualitative research guidelines. Twelve mothers of children with early onset scoliosis were interviewed, as only mothers consented to participate. Four major themes emerged: emotional rollercoaster ride, a lack of resources, money talks and pervasive burden. Factors that impacted on the participants' ability to confront, manage and endure caring for a child with early onset scoliosis emerged from the data. The findings suggest there are multiple factors that influence the experience of mothers' caring for a child with early onset scoliosis. The recognition and appropriate management of these factors by healthcare professionals have the potential to improve the quality of life of parents who care for a child with early onset scoliosis. Healthcare professionals have first-line contact with parents of children with early onset scoliosis and are well placed to provide parents with evidence-based education

  6. Careful or lenient : welfare reform for lone mothers in the Netherlands

    NARCIS (Netherlands)

    Knijn, Trudie; Wel, Frits van

    2001-01-01

    The 1996 welfare reform that attempted to get lone parents out of social assistance represents a major shift in social policy in the Netherlands. Instead of having the financial right to care for their children, lone mothers are now obliged to earn their living by paid work as soon as their youngest

  7. Intervention pattern in crisis: mental health as a nursing care approach at a general hospital

    OpenAIRE

    Oliveira, Elias Barbosa; Kestenberg, Célia Caldeira Fonseca; Silva, Alexandre Vicente

    2013-01-01

    Objective: Testing and validating the application of Intervention in Crisis theory as an approach in mental health on HIV/AIDS patients care who are interned at a general hospital. Method: Help Interview has been accomplished as an activity for Mental Health subject according to an applied guide by graduation in nursing students in order to identify this illness psycho-social repercussion and draft therapeutic plan for patients under their care. The outcomes were the reports results presented...

  8. Hypertensive crisis in children: an experience in a single tertiary care center in Korea.

    Science.gov (United States)

    Lee, Geum Hwa; Lee, I Re; Park, Se Jin; Kim, Ji Hong; Oh, Ji Young; Shin, Jae Il

    2015-01-01

    pressure monitoring and careful examinations should be mandatory in children with underlying disease, especially renal diseases and cancer. Furthermore, both nicardipine and labetalol may be effective antihypertensive drug in lowering high blood pressure in children with hypertensive crisis.

  9. Level of modern health care seeking behaviors among mothers having under five children in Dangila town, north West Ethiopia, 2016: a cross sectional study.

    Science.gov (United States)

    Dagnew, Amare Belachew; Tewabe, Tilahun; Murugan, Rajalakshmi

    2018-05-29

    Health seeking behavior is an action taken by an individual who perceive to have a health problem. In most developing countries including Ethiopia the health of the children is strongly dependant on maternal health care behavior. Most childhood morbidities and mortalities are associated with low level of mothers health care seeking behavior. Therefore, the objective of this study was to assess level of modern health care seeking behavior among mothers having under five children in Dangila town, North West Ethiopia. Community based quantitative cross-sectional study was conducted from April 15 to May 15, 2016. Systematic random sampling technique was used to select study participants. A total of273 mothers with children less than five years were included in this study. The data was collected from all five Kebeles using interviewer administered questionnaire. Descriptive and inferential statistics were used to present the data. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with level of modern health care seeking behavior. Prevalence of modern health care seeking behavior was 82.1%. Age of mothers (AOR = 2.4(1.1, 5.3), age of the child (AOR = 6.7(2.8, 22.2), severity of illness (AOR = 5.2(1.2, 22.6) and family number (AOR = 6.4(2.1, 20.2) were predictors of modern health care seeking behavior among mothers. Majority of the mothers preferred to take their children to modern health care when they got illness. Age of children, age of mother, number of family and severity of illness were the determinant factors for modern health care seeking behavior. Therefore, health care services should be strengthened at community level through community integrated management of childhood illness, information, education communication / behavioral change communication strategies to improve mothers health care seeking behaviors.

  10. Consequences of Teen Parents’ Child Care Arrangements for Mothers and Children*

    Science.gov (United States)

    Mollborn, Stefanie; Blalock, Casey

    2013-01-01

    Using the nationally representative Early Childhood Longitudinal Study-Birth Cohort (2001 - 2006; N ≈ 7900), we examined child care arrangements among teen parents from birth through prekindergarten. Four latent classes of child care arrangements at 9, 24, and 52 months emerged: “parental care,” “center care,” “paid home-based care,” and “free kin-based care.” Disadvantaged teen-parent families were overrepresented in the “parental care” class, which was negatively associated with children’s preschool reading, math, and behavior scores and mothers’ socioeconomic and fertility outcomes compared to some nonparental care classes. Nonparental care did not predict any negative maternal or child outcomes, and different care arrangements had different benefits for mothers and children. Time spent in nonparental care and improved maternal outcomes contributed to children’s increased scores across domains. Child care classes predicted maternal outcomes similarly in teen-parent and nonteen-parent families, but the “parental care” class predicted some disproportionately negative child outcomes for teen-parent families. PMID:23729861

  11. When disaster strikes -- caring for mothers and babies. Special feature -- mothers as refugees.

    Science.gov (United States)

    1997-01-01

    In many countries, women are poorly nourished and have a high rate of reproductive morbidity. However, during war and other disaster situations, women and children become even more vulnerable. Most of the world's refugees and internally displaced people are women and children. Many women refugees are malnourished and during the emergency and exodus phases, many are starving. Severe malnutrition in a pregnant woman causes fetal malnutrition. Infants born to a malnourished mother are of low birth weight and will grow up malnourished if they stay in the same deprived environment as their mothers. Households headed by women tend to obtain the least food and the children of such households tend to be poorly nourished. Many of the problems and obstacles women face during peacetime and non-emergency situations are simply exacerbated during disasters and war. It may not be possible to head off disasters which result in massive social upheaval, but preparations can nonetheless be made to mollify conditions once disaster hits. Responsible organizations and agencies should research the situation and plan for the worst. This paper discusses how women lose social and economic power during periods of armed conflict, the often lack of even basic reproductive health care during armed conflict and emergencies, coping in an emergency, and living in a refugee camp.

  12. Antenatal Care Seeking Behaviour among Slum Mothers: A Study of Rajshahi City Corporation, Bangladesh.

    Science.gov (United States)

    Rahman, Mahfuzar; Islam, Rafiqul; Rahman, Mosfequr

    2010-04-01

    The study aimed to identify the important effects of some selected variables in antenatal care (ANC) seeking behaviour among slum mothers. The data for the study were collected in 2006 from 700 mothers in the slum areas of Rajshahi City Corporation (RCC), Bangladesh. The results indicate that tetanus toxoid (TT) is relatively widespread in slum areas of RCC. Serious health implications were observed for the mothers and their children who lived in the study areas because more than half of the respondents (56.1%) were not assisted at their last childbirth by any health professional. The respondents were too poor to buy iron tablets/syrup and vitamin tablets/syrup during their last pregnancy. The application of a logistic regression model suggested that demographic and socio-economic factors were associated with ANC seeking behaviour among slum mothers. Respondents' education, place of treatment, husband's occupation, family's income, and exposure to mass media had highly significant effects on mothers seeking medical checkups during their last pregnancy.

  13. Cultural care practices among mothers of nurslings with respiratory infection - doi: 10.5020/18061230.2012.s13

    Directory of Open Access Journals (Sweden)

    Dayanne Rakelly de Oliveira

    2012-11-01

    Full Text Available Objective: To understand the cultural practices of care among mothers of infants with respiratory infection in a pediatric outpatient clinic, from the recognition of the importance of the use of traditional medicine in Brazil. Methods: We applied a descriptive and exploratory study, qualitative, with twenty-eight mothers of infants with respiratory infection seen at a referral center in the city of Barbalha - CE, Brazil. Data were collected between the months of November and December of 2010 through semi-structured interview with a tape recorder. The speeches were analyzed by thematic-categorical analysis, which allowed the creation of four themes: cultural practices of care among mothers, sources of information on medicinal plants, modes of preparation of medicinal herbs and plants used by mothers. To ensure anonymity of participants, they received enumeration following the order of interviews. Results: The study showed that mothers make use of folk medicine, through the preparation of home remedies in order to treat and cure respiratory infections of their children; the leaking tea and herbal medicine are worth mentioning. Mothers place great confidence and give real meaning to the use of homemade preparations. It was observed that this knowledge comes from their mothers, grandparents, relatives and neighbors. Conclusion: Mothers attach great importance to popular practice, the traditional knowledge of relevant cultural value, as it is transmitted from generation to generation and has been rebuilt over time.

  14. FACTORS LEAD TO DEPRESION DURING ANTENATAL CARE EVERY TRIMESTER OF PREGNANT MOTHER

    Directory of Open Access Journals (Sweden)

    Eddy Surya Kurniawan

    2013-03-01

    Full Text Available The most important factor in reducing maternal and infant mortality rates began during pregnancy. In 2000, one in twenty children die before reaching the age of five years and a mother died of childbirth out of every 325 live births. The death rate in research mainly indicated comparable levels of depression due to stress in pregnant women. The occurrence of symptoms of depression during the perinatal period can be easily recognized. Depression during pregnancy is a common mood disorder such as depression that occurs in the laity in general, where the incidence of depression will occur chemical changes in the brain. Each trimester of pregnancy are at risk of psychological disorders respectively. Antenatal care plays a very important for the safety of the mother and fetus, minimizing the risks of pregnancy, and reduce the number of neonatal deaths. Nursing antenatal care should have run in accordance with minimum standards for pregnant women to obtain a safe childbirth and satisfying.

  15. The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study

    Directory of Open Access Journals (Sweden)

    van Teijlingen Edwin R

    2010-07-01

    Full Text Available Abstract Background Antenatal care (ANC has been recognised as a way to improve health outcomes for pregnant women and their babies. However, only 29% of pregnant women receive the recommended four antenatal visits in Nepal but reasons for such low utilisation are poorly understood. As in many countries of South Asia, mothers-in-law play a crucial role in the decisions around accessing health care facilities and providers. This paper aims to explore the mother-in-law's role in (a her daughter-in-law's ANC uptake; and (b the decision-making process about using ANC services in Nepal. Methods In-depth interviews were conducted with 30 purposively selected antenatal or postnatal mothers (half users, half non-users of ANC, 10 husbands and 10 mothers-in-law in two different (urban and rural communities. Results Our findings suggest that mothers-in-law sometime have a positive influence, for example when encouraging women to seek ANC, but more often it is negative. Like many rural women of their generation, all mothers-in-law in this study were illiterate and most had not used ANC themselves. The main factors leading mothers-in-law not to support/encourage ANC check ups were expectations regarding pregnant women fulfilling their household duties, perceptions that ANC was not beneficial based largely on their own past experiences, the scarcity of resources under their control and power relations between mothers-in-law and daughters-in-law. Individual knowledge and social class of the mothers-in-law of users and non-users differed significantly, which is likely to have had an effect on their perceptions of the benefits of ANC. Conclusion Mothers-in-law have a strong influence on the uptake of ANC in Nepal. Understanding their role is important if we are to design and target effective community-based health promotion interventions. Health promotion and educational interventions to improve the use of ANC should target women, husbands and family members

  16. The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study.

    Science.gov (United States)

    Simkhada, Bibha; Porter, Maureen A; van Teijlingen, Edwin R

    2010-07-01

    Antenatal care (ANC) has been recognised as a way to improve health outcomes for pregnant women and their babies. However, only 29% of pregnant women receive the recommended four antenatal visits in Nepal but reasons for such low utilisation are poorly understood. As in many countries of South Asia, mothers-in-law play a crucial role in the decisions around accessing health care facilities and providers. This paper aims to explore the mother-in-law's role in (a) her daughter-in-law's ANC uptake; and (b) the decision-making process about using ANC services in Nepal. In-depth interviews were conducted with 30 purposively selected antenatal or postnatal mothers (half users, half non-users of ANC), 10 husbands and 10 mothers-in-law in two different (urban and rural) communities. Our findings suggest that mothers-in-law sometime have a positive influence, for example when encouraging women to seek ANC, but more often it is negative. Like many rural women of their generation, all mothers-in-law in this study were illiterate and most had not used ANC themselves. The main factors leading mothers-in-law not to support/encourage ANC check ups were expectations regarding pregnant women fulfilling their household duties, perceptions that ANC was not beneficial based largely on their own past experiences, the scarcity of resources under their control and power relations between mothers-in-law and daughters-in-law. Individual knowledge and social class of the mothers-in-law of users and non-users differed significantly, which is likely to have had an effect on their perceptions of the benefits of ANC. Mothers-in-law have a strong influence on the uptake of ANC in Nepal. Understanding their role is important if we are to design and target effective community-based health promotion interventions. Health promotion and educational interventions to improve the use of ANC should target women, husbands and family members, particularly mothers-in-law where they control access to family

  17. The correlation between mothers' participation in infant care in the NICU and their anxiety and problem-solving skill levels in caregiving.

    Science.gov (United States)

    Çakmak, Emine; Karaçam, Zekiye

    2018-01-01

    To examine the correlation between mothers' participation in infant care in the Neonatal Intensive Care Unit (NICU) and their anxiety and problem-solving skill levels in caregiving. The cross-sectional study was conducted with 340 mothers whose babies were in the NICU. Data were collected with a questionnaire, a Participation in Caregiving Observation Form, the State and Trait Anxiety Inventory and the Problem-solving Skills Evaluation Form. Descriptive statistics and correlation analysis were used in the evaluation of the data. The mothers were with their babies an average of 6.28 ± 2.43 (range: 1-20) times a day, participating in many basic procedures of care. A negative correlation was found between the mothers' scores on the Participation in Caregiving Observation Form and their State and Trait Anxiety Inventory scores (respectively, r = -0.48, p Problem-solving Process (r = 0.41, p problem-solving skills with respect to baby care and related problems.

  18. Mothers of children diagnosed with attention-deficit/hyperactivity disorder: health conditions and medical care utilization in periods before and after birth of the child.

    Science.gov (United States)

    Ray, G Thomas; Croen, Lisa A; Habel, Laurel A

    2009-01-01

    Analyzing health conditions and medical utilization of mothers of children with attention-deficit/hyperactivity disorder (ADHD) can shed light on biologic, environmental, and psychosocial factors relating to ADHD. To examine health conditions, health care utilization, and costs of mothers of children with ADHD in periods before the child was diagnosed. Using automated data from Northern California Kaiser Permanente we identified mothers of children with ADHD, mothers of children without ADHD, and mothers of children with asthma. Mothers' diagnostic clusters, health care utilization, and costs were compared. Mothers of children with ADHD were compared with mothers of children without ADHD and, separately, to mothers of children with asthma. Compared with mothers of children without ADHD, mothers of children with ADHD were more likely to be diagnosed with numerous medical and mental health problems in the 2 years after birth of their child, including depression [odds ratio (OR): 1.88], anxiety neuroses (OR: 1.64), obesity (OR: 1.70), and musculoskeletal symptoms (OR: 1.51). Results were similar for the year before delivery. Mothers of children with ADHD also had higher total health care costs per person in the year before ($1,003) and the 2 years after ($953) the birth of their child. Mothers of children with ADHD also were diagnosed with more health conditions and had higher health care costs than mothers of children with asthma. Our findings suggest that the likelihood of being diagnosed with ADHD is related to maternal conditions and use of health services that precede the child's diagnosis. Future studies are needed to clarify whether this is due to biologic, psychosocial, or environmental factors, or a combination.

  19. Comparison outcomes of sick babies born to teenage mothers with those born to adult mothers.

    Science.gov (United States)

    Chotigeat, Uraiwan; Sawasdiworn, Siraporn

    2011-08-01

    Adolescent period is the transitional stage of physical and mental development from childhood to adulthood. Pregnancy in teenage girls is generally classified to have a higher risk than those in adults. In many previous studies reported only the outcome of teenage mothers but no comparative outcome between sick babies born to teen mothers and adult mothers, so the authors conducted the present study. To compare the outcomes of sick infants born to teenage mothers with those born to adult mothers (age > or = 20 years). This prospective study was carried out from October 1st, 2006 to September 30th, 2009. The study group consisted of sick babies born to teenage mothers and admitted at Queen Sirikit National Institute of Child Health (QSNICH). These babies were compared to sick babies (control group) born to adult mothers during the same period. The demographic data of mothers and sick babies in both groups were recorded in the designed case record forms. Developmental assessment was done until two years of age. A total of 6,342 deliveries took place in Rajavithi Hospital during the study period of which 697 babies were born to teenage mothers. The incidence of teenage pregnancy was 10.99%. The number of sick babies from teenage mothers and adult mothers were 78 and 147 cases, respectively. There was a significantly higher mortality in the study group (7 cases, 9%) than the control group (4 cases, 2.7%). There was statistically significant difference in most of the demographic characteristics between the teenage and adult mothers except anemia, PROM and MSAF (meconium stain amniotic fluid). Although there was a trend of more cases of anemia and MSAF in teenage mothers than in adult mothers, there was no statistically significant difference. There was a shorter interval time from marriage to pregnancy in teen mothers than in adult mothers and a lower number of antenatal care visits with late antenatal care among the teenage mothers too. On comparing the data in infants

  20. Veterans Crisis Line

    Data.gov (United States)

    Department of Veterans Affairs — The caring responders at the Veterans Crisis Line are specially trained and experienced in helping Veterans of all ages and circumstances. Some of the responders are...

  1. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... Crisis Centers About Be There Show You Care Find Resources Graphic Generator Toolkit Signs of Crisis Identifying ... or a Veteran you know is in crisis, find a facility near you. Spread the Word Download ...

  2. OBSERVATION ON INCREASE IN WEIGHT OF LOW BIRTH WEIGHT (LBW BABIES BY IMPLEMENTING KANGAROO MOTHER CARE (KMC TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Purnendu Kumar Singh

    2014-12-01

    Full Text Available Kangaroo Mother Care (KMC is a practical technique for nursing of low birth weight babies by direct skin to contact with the mother. This study was undertaken to observe and record the effect of KMC with focus on increase in weight of at term low birth weight (LBW babies weighing less than 2000 grams. The study was conducted over thirty six month’s period from July 2011 to June 2014. The method of care consisted of skin to skin contact between the mother and the infant along with exclusive breast milk. Upon implementation of KMC babies under observation showed satisfactory gain in weight of average 25grams per day and an average hospital stay of 10 days. KMC aims towards achieving good weight gain in LBW babies. It is a simple hassle free technique which can be implemented at all levels of health care.

  3. United front may help prevent crisis.

    Science.gov (United States)

    2003-03-01

    Warnings of looming crisis are all around us, including within services for older people. Recent reports warn that the care home sector is reaching a critical juncture and, without long-term planning and investment, crisis will turn to meltdown ( Burstow 2003 ). In the past five years something like 50,000 long-term care beds have been lost and now, according to the National Audit Office, tens of thousands of older people each year find themselves unable to leave hospital because there is insufficient post-hospital care (see page five ). Emergency hospital readmissions have increased by nearly 20 per cent over the past two years and the reality of intermediate care has yet to live up to the policy rhetoric.

  4. Perceptions of Adult Women on Losing Their Mothers at an Early Age: Implications for Nursing Care During Childbirth.

    Science.gov (United States)

    Gunn, Jennie; Huebner, Carroll Gunn; McCoy, Kristen

    To explore the lived experience of women over the age of 21 who lost their mothers before the age of 18. Using qualitative methodology, motherless child-adult women were gathered through emails, word of mouth, and snowballing techniques. Interviews were conducted at the convenience of the women. The women coparticipated with identification of emerging themes using thematic analysis. Eight women who lost their mothers before the age of 18 participated. Eight themes emerged: (1) Understanding: For wounded hearts only; (2) Coming apart: Finding my mother's daughter and self-worth; (3) Unconditional love: Grieving for and identifying with my champion; (4) Finding help: Filling the empty place with God; (5) Pitying the motherless child: Making it worse; (6) Filling in: Others as mother; (7) The ebb and flow: Grieving; and (8) Becoming mother: Taking on the Role. The nurse has the opportunity to improve care for women who lost their mothers before the age of 18 years. During pregnancy, childbirth, and childrearing, the woman may feel sad and anxious without the guidance of her mother. Special ways of caring may be instituted to provide her comfort such as allowing and encouraging her to bring a special item of her mother's to procedures and events so that she may feel connected with her, allowing someone to stand in for her mother, perhaps assisting in finding of another motherless child adult to be with her as needed, and the voicing of understanding of her loss while remaining nonjudgmental about her emotions during these times.

  5. [Actual care and funding situation with regard to mother-child units for psychic disorders associated with pregnancy in Germany].

    Science.gov (United States)

    Jordan, Wolfgang; Bielau, Hendrik; Cohrs, Stefan; Hauth, Iris; Hornstein, Christiane; Marx, Alexandra; Reck, Corinna; von Einsiedel, Regina

    2012-07-01

    CONCERN: The current care and financial situation of mother-child units for psychic disorders associated with pregnancies in Germany should be documented in preparation for the development of the new reimbursement system for psychiatry and psychosomatics. In accordance with the last survey of 2005, a brief questionnaire was developed and a nationwide poll was conducted. The survey revealed severe (10 fold) service deficits for severely and gravely mentally ill mothers, who require an inpatient treatment with specific professional competence. Compared with the last poll, these service deficits have increased. This is due to continued insufficient funding and unresolved financing in the new reimbursement system. With the establishment of an additional code for mother-child treatment the precondition for ensuring the funding of this important care form in the new reimbursement system was created. It is to be hoped that the decision-makers of health policy will finally face up to their social responsibility and ensure adequate funding of the additional diagnostic and therapeutic expenditure of mother-child treatment. The health care providers have an obligation to implement a transparent record of services of the additional expenditure and to augment the national evaluation approaches to inpatient mother-child treatments. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Changes in morbidity and medical care utilization after the recent economic crisis in the Republic of Korea.

    Science.gov (United States)

    Kim, Hanjoong; Chung, Woo Jin; Song, Young Jong; Kang, Dae Ryong; Yi, Jee Jeon; Nam, Chung Mo

    2003-01-01

    To examine and quantify the impact of the recent economic crisis on morbidity and medical care utilization in the Republic of Korea. 22 675 people from 6791 households and 43 682 people from 12 283 households were questioned for two nationwide surveys that took place in 1995 and 1998, respectively. A separate sample pretest-posttest design was used and we conducted c2 test and logistic regression analysis after controlling for the maturation effect of the morbidity and medical care utilization. The morbidity rates of chronic disease and acute disease increased significantly by 27.1% and 9.5%, respectively, whereas the utilization rates of outpatient and inpatient services decreased by 15.1% and 5.2%, respectively. In particular, the pace of decline in the utilization rate of outpatient services varied depending on the type of disease: morbidity rates for mental and behavioural disorders were 13.7%; for cardiovascular disease, 7.1%; and for injury, 31.6%. After the Republic of Korean economic crisis, the morbidity and medical care utilization rates changed significantly but the degree of change depended on the type of disease or service. The time-dependent relationship between the national economy and the morbidity and medical care utilization rates needs to be further investigated.

  7. The Effect of Kangaroo Mother Care on Fuss and Crying Time in Colicky Infants

    Directory of Open Access Journals (Sweden)

    Zahra Akbarian Rad

    2015-03-01

    Full Text Available AbstractBackground: Infantile colic is a common complaint in the first few weeks of life. On the other hand, because of its unknown etiology, there is not a specific therapy for this complaint, but various therapeutic options for reducing pain and restlessness of these infants are recommended. Skin to skin contact by Kangaroo Mother Care (KMC increases in pain threshold and it seems to be a suitable method for the care of these infants. This study was designed to evaluate the effect of KMC on infantile colic.Methods: This case- control study was performed between March 2012 and March 2013. Subjects were 55 infants with exclusive breast fed infant, aged 15-60 days with excessive fuss and crying, referred to Infant and Child Clinic in Ayatollah Rohani Hospital in Babol, north of Iran. Babies whose weights were less than 2500 Grams and with inheritance and clinical diseases excluded from the study. Infants were subjected to KMC at least 2 hours a day. Standard questionnaire and Barr Scale were filled by interview. Data was analyzed by SPSS v.11.5 and T-test, a P- value less than 0.05 considered being significant.Results:The fuss and crying time before the KMC was 2.21±1.54 hours per day and decreased to 1.16±1.3 hours per day after the implementation of KMC. (p=0.001Conclusions:Kangaroo mother care at home can be used as a simple and safe method for decreasing of cry and fussiness in colicky infants. Keywords: Kangaroo Mother Care (KMC, fussiness, Colicky Infants, colic

  8. The Effect of Kangaroo Mother Care on Fuss and Crying Time in Colicky Infants

    Directory of Open Access Journals (Sweden)

    Zahra Akbarian Rad

    2015-03-01

    Full Text Available Background: Infantile colic is a common complaint in the first few weeks of life. On the other hand, because of its unknown etiology, there is not a specific therapy for this complaint, but various therapeutic options for reducing pain and restlessness of these infants are recommended. Skin to skin contact by Kangaroo Mother Care (KMC increases in pain threshold and it seems to be a suitable method for the care of these infants. This study was designed to evaluate the effect of KMC on infantile colic. Methods: This case- control study was performed between March 2012 and March 2013. Subjects were 55 infants with exclusive breast fed infant, aged 15-60 days with excessive fuss and crying, referred to Infant and Child Clinic in Ayatollah Rohani Hospital in Babol, north of Iran. Babies whose weights were less than 2500 Grams and with inheritance and clinical diseases excluded from the study. Infants were subjected to KMC at least 2 hours a day. Standard questionnaire and Barr Scale were filled by interview. Data was analyzed by SPSS v.11.5 and T-test, a P- value less than 0.05 considered being significant. Results: The fuss and crying time before the KMC was 2.21±1.54 hours per day and decreased to 1.16±1.3 hours per day after the implementation of KMC. (p=0.001 Conclusions: Kangaroo mother care at home can be used as a simple and safe method for decreasing of cry and fussiness in colicky infants. Keywords: Kangaroo Mother Care (KMC, fussiness, Colicky Infants, colic

  9. Comparison in stress of caring mothers of children with developmental, external and internal disorders and normal children

    Directory of Open Access Journals (Sweden)

    Narges Zamani

    2017-06-01

    Full Text Available However, having a baby brings positive emotions such as happiness, sense of maturity and proud, parenting's issue could cause high level of stress and child's characteristics was a detrimental factor which can effect on parent's stress, so the aim of this research was comparison of stress of caring in mothers of children with developmental, external, and internal disorders and normal children. The study population included all mothers of children with developmental, emotional, and disruptive behavior disorders, and mothers with normal children in Hamadan (a city in Iran. 240 mothers (4 groups include 60 mothers were chosen based on simple random sampling. Family inventory of life events and changes Mc Cubbin, Patterson & Wilson was used for assessing participants. The results showed that maternal stress in mothers with children who have diagnosis of disruptive behavior disorders were significantly more than of mothers of children with developmental disorders, emotional and mothers of normal children. The present study showed that disruptive behavior disorders in children have a greater impact on their mothers. So, we suggest approved psychological interventions for helping mothers of children with psychological problems, particularly children with external disorders.

  10. Medical Supplies Shortages and Burnout among Greek Health Care Workers during Economic Crisis: a Pilot Study

    Science.gov (United States)

    Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K.; Dounias, George; Hadjichristodoulou, Christos

    2014-01-01

    Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country. PMID:24688306

  11. Normative cultural values and the experiences of Mexican-American mothers in the neonatal intensive care unit.

    Science.gov (United States)

    Cleveland, Lisa M; Horner, Sharon D

    2012-04-01

    To explore the experiences of Mexican-American mothers who have had infants in the neonatal intensive care unit (NICU). A convenience sample of 15 English-speaking, Mexican-American women was interviewed. The study used an exploratory qualitative approach. Data collection was conducted through audiotaped, transcribed, semistructured, individual interviews and field notes. The 5 normative cultural values for Latino families-(1) simpatia, (2) personalismo, (3) respeto, (4) familismo, and (5) fatalismo-were used as a sensitizing framework to guide data interpretation. The women's discussions of their NICU experiences clearly reflect the 5 normative Latino cultural values. Positive and negative exemplars of these values are provided as evidence. These findings can be used to inform nursing care provided for Mexican-American mothers and their infants by assisting nurses to customize care to meet the cultural needs of this population.

  12. Support by trained mentor mothers for abused women: a promising intervention in primary care.

    Science.gov (United States)

    Prosman, Gert-Jan; Lo Fo Wong, Sylvie H; Lagro-Janssen, Antoine L M

    2014-02-01

    Intimate partner violence (IPV) against women is a major health problem and negatively affects the victim's mental and physical health. Evidence-based interventions in family practice are scarce. We aimed to evaluate a low threshold home-visiting intervention for abused women provided by trained mentor mothers in family practice. The aim was to reduce exposure to IPV, symptoms of depression as well as to improve social support, participation in society and acceptance of mental health care. A pre-post study of a 16-week mentoring intervention with identified abused women with children was conducted. After referral by a family doctor, a mentor mother visited the abused woman weekly. Primary outcomes are IPV assessed with the Composite Abuse Scale (CAS), depressive symptoms using the Symptom Checklist (SCL 90) and social support by the Utrecht Coping List. Secondary outcomes are analysed qualitatively: participation in society defined as employment and education and the acceptance of mental health care. At baseline, 63 out of 66 abused women were referred to mentor support. Forty-three participants completed the intervention programme. IPV decreased from CASt otal 46.7 (SD 24.7) to 9.0 (SD 9.1) (P ≤ 0.001) after the mentor mother support programme. Symptoms of depression decreased from 53.3 (SD 13.7) to 34.8 (SD 11.5) (P ≤ 0.001) and social support increased from 13.2 (SD 4.0) to 15.2 (SD 3.5) (P ≤ 0.001). Participation in society and the acceptance of mental health for mother and child improved. Sixteen weekly visits by trained mentor mothers are a promising intervention to decrease exposure to IPV and symptoms of depression, as well as to improve social support, participation in society and the acceptance of professional help for abused women and their children.

  13. A life uncertain - My baby's vulnerability: Mothers' lived experience of connection with their preterm infants in a Botswana neonatal intensive care unit.

    Science.gov (United States)

    Ncube, Rosinah K; Barlow, Hilary; Mayers, Pat M

    2016-08-30

    Preterm and low-birth weight infants are often separated from their mothers when admitted to neonatal units for stabilisation of body temperature and technological support. The aim of the study was to explore and describe the lived experiences of mothers regarding care of their hospitalised preterm infants in a neonatal unit in a public hospital in Gaborone, Botswana. This study utilised a qualitative exploratory and descriptive phenomenological study design. Mothers of hospitalised preterm infants were purposefully selected, with whom there was extensive engagement. Two in-depth interviews were conducted with each participant (P). Mothers were shocked by the sudden birth of a preterm infant and found the neonatal environment intimidating. This increased their fear and anxiety and delayed development of a relationship with their infants. Support from staff, other mothers in the neonatal unit and family members enabled the mothers to overcome their fear and to develop an emotional connection with their infants. On-going supportive communication with the mothers by healthcare professionals promotes their confidence and competence in caring for their preterm infants, which in turn promotes mother-infant attachment.

  14. The Impact of the 1997-1998 East Asian Economic Crisis on Health and Health Care in Indonesia

    NARCIS (Netherlands)

    Pradhan, M.P.; Waters, H.; Saadah, F.

    2003-01-01

    This article identifies the effects of the 1997-98 East Asian economic crisis on health care use and health status in Indonesia. The article places the findings in the context of a framework showing the complex cause and effect relationships underlying the effects of economic downturns on health and

  15. Uptake, outcomes, and costs of antenatal, well-baby, and prevention of mother-to-child transmission of HIV services under routine care conditions in Zambia.

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    Callie A Scott

    Full Text Available BACKGROUND: Zambia adopted Option A for prevention of mother-to-child transmission of HIV (PMTCT in 2010 and announced a move to Option B+ in 2013. We evaluated the uptake, outcomes, and costs of antenatal, well-baby, and PMTCT services under routine care conditions in Zambia after the adoption of Option A. METHODS: We enrolled 99 HIV-infected/HIV-exposed (index mother/baby pairs with a first antenatal visit in April-September 2011 at four study sites and 99 HIV-uninfected/HIV-unexposed (comparison mother/baby pairs matched on site, gestational age, and calendar month at first visit. Data on patient outcomes and resources utilized from the first antenatal visit through six months postpartum were extracted from site registers. Costs in 2011 USD were estimated from the provider's perspective. RESULTS: Index mothers presented for antenatal care at a mean 23.6 weeks gestation; 55% were considered to have initiated triple-drug antiretroviral therapy (ART based on information recorded in site registers. Six months postpartum, 62% of index and 30% of comparison mother/baby pairs were retained in care; 67% of index babies retained had an unknown HIV status. Comparison and index mother/baby pairs utilized fewer resources than under fully guideline-concordant care; index babies utilized more well-baby resources than comparison babies. The average cost per comparison pair retained in care six months postpartum was $52 for antenatal and well-baby services. The average cost per index pair retained was $88 for antenatal, well-baby, and PMTCT services and increased to $185 when costs of triple-drug ART services were included. CONCLUSIONS: HIV-infected mothers present to care late in pregnancy and many are lost to follow up by six months postpartum. HIV-exposed babies are more likely to remain in care and receive non-HIV, well-baby care than HIV-unexposed babies. Improving retention in care, guideline concordance, and moving to Option B+ will result in

  16. Newborn care practices in rural Bangladesh: Implications for the adaptation of kangaroo mother care for community-based interventions.

    Science.gov (United States)

    Hunter, Erin C; Callaghan-Koru, Jennifer A; Al Mahmud, Abdullah; Shah, Rashed; Farzin, Azadeh; Cristofalo, Elizabeth A; Akhter, Sadika; Baqui, Abdullah H

    2014-12-01

    Bangladesh has one of the world's highest rates of low birth weight along with prevalent traditional care practices that leave newborns highly vulnerable to hypothermia, infection, and early death. We conducted formative research to explore existing newborn care practices in rural Bangladesh with an emphasis on thermal protection, and to identify potential facilitators, barriers, and recommendations for the community level delivery of kangaroo mother care (CKMC). Forty in-depth interviews and 14 focus group discussions were conducted between September and December 2012. Participants included pregnant women and mothers, husbands, maternal and paternal grandmothers, traditional birth attendants, village doctors, traditional healers, pharmacy men, religious leaders, community leaders, and formal healthcare providers. Audio recordings were transcribed and translated into English, and the textual data were analyzed using the Framework Approach. We find that harmful newborn care practices, such as delayed wrapping and early initiation of bathing, are changing as more biomedical advice from formal healthcare providers is reaching the community through word-of-mouth and television campaigns. While the goal of CKMC was relatively easily understood and accepted by many of the participants, logistical and to a lesser extent ideological barriers exist that may keep the practice from being adopted easily. Women feel a sense of inevitable responsibility for household duties despite the desire to provide the best care for their new babies. Our findings showed that participants appreciated CKMC as an appropriate treatment method for ill babies, but were less accepting of it as a protective method of caring for seemingly healthy newborns during the first few days of life. Participants highlighted the necessity of receiving help from family members and witnessing other women performing CKMC with positive outcomes if they are to adopt the behavior themselves. Focusing intervention

  17. Intra-facility linkage of HIV-positive mothers and HIV-exposed babies into HIV chronic care: rural and urban experience in a resource limited setting.

    Directory of Open Access Journals (Sweden)

    Christine Mugasha

    Full Text Available INTRODUCTION: Linkage of HIV-infected pregnant women to HIV care remains critical for improvement of maternal and child outcomes through prevention of maternal-to-child transmission of HIV (PMTCT and subsequent chronic HIV care. This study determined proportions and factors associated with intra-facility linkage to HIV care and Early Infant Diagnosis care (EID to inform strategic scale up of PMTCT programs. METHODS: A cross-sectional review of records was done at 2 urban and 3 rural public health care facilities supported by the Infectious Diseases Institute (IDI. HIV-infected pregnant mothers, identified through routine antenatal care (ANC and HIV-exposed babies were evaluated for enrollment in HIV clinics by 6 weeks post-delivery. RESULTS: Overall, 1,025 HIV-infected pregnant mothers were identified during ANC between January and June, 2012; 267/1,025 (26% in rural and 743/1,025 (74% in urban facilities. Of these 375/1,025 (37% were linked to HIV clinics [67/267(25% rural and 308/758(41% urban]. Of 636 HIV-exposed babies, 193 (30% were linked to EID. Linkage of mother-baby pairs to HIV chronic care and EID was 16% (101/636; 8/179 (4.5%] in rural and 93/457(20.3% in urban health facilities. Within rural facilities, ANC registration <28 weeks-of-gestation was associated with mothers' linkage to HIV chronic care [AoR, 2.0 95% CI, 1.1-3.7, p = 0.019] and mothers' multi-parity was associated with baby's linkage to EID; AoR 4.4 (1.3-15.1, p = 0.023. Stigma, long distance to health facilities and vertical PMTCT services affected linkage in rural facilities, while peer mothers, infant feeding services, long patient queues and limited privacy hindered linkage to HIV care in urban settings. CONCLUSION: Post-natal linkage of HIV-infected mothers to chronic HIV care and HIV-exposed babies to EID programs was low. Barriers to linkage to HIV care vary in urban and rural settings. We recommend targeted interventions to rapidly improve linkage to

  18. Economic crisis and women's labor force return after childbirth: Evidence from South Korea

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    Li Ma

    2014-08-01

    Full Text Available Background: Most research on women's labor force return after childbirth concentrates on industrialized countries in the West; the link between economic swings and mothers' work-return behavior is rarely addressed. This study closes these gaps by focusing on South Korea, a developed society in East Asia that has in recent decades witnessed increases in female labor force participation and dramatic economic ups and downs. This is the first relevant study on South Korea. Objective: This study examines how women's labor force return after childbirth (with and without career interruption and their career prospects upon work return varied before, during, and after the Asian financial crisis in South Korea. Methods: Logistic and hazard regression models were applied to the Korea Labor and Income Panel Study (KLIPS waves 1-10. Results: The study reveals an increase in women's immediate work return after childbirth without career interruption since the 1980s. The Asian financial crisis boosted this immediate return pattern. The implementation of job-protected maternity leave further contributed to this pattern. Women who underwent career interruption at first birth were also more likely to re-enter the labor market during and after the crisis than before. Downward occupational moves were especially common during the period of financial crisis. Conclusions: The results suggest that the Asian financial crisis triggered a noticeable change in women's post-birth work-return behavior. The economic volatility pushed mothers to hold onto their role in the labor force more strongly than before.

  19. Quality of antenatal care provided by nurse midwives in an Urban health centre with regard to low-risk antenatal mothers

    Directory of Open Access Journals (Sweden)

    Ruby Angeline Pricilla

    2017-01-01

    Full Text Available Background:India contributes to 19% of the global maternal deaths. Good quality antenatal care can prevent maternal deaths by early detection of complications and maintaining maternal health. There are few studies documenting quality of antenatal care in India. This study aimed to document the antenatal services provided by nurse midwives to low-risk pregnant mothers from an urban population. Aims: The primary objective was to describe the quality of the antenatal care provided by nurse midwives of an urban health centre with regard to low-risk mothers. The secondary objective was to document the maternal and early neonatal outcomes of the enrolled mothers during the period of study. Methods: This prospective cohort study was done on 200 pregnant women who had antenatal care by nurse midwives between April 2014 and November 2014. The quality of care was assessed by a checklist adapted from World Health Organization (WHO. Results: We report that the quality of antenatal care for all domains was above 90% except for the health education domain, which was poor with regard to breastfeeding and family planning in the enrolled 200 pregnant women. Conclusion: Our study concluded that trained nurse midwives when regularly monitored, audited and linked with reliable referral facilities can deliver good quality antenatal care.

  20. Promoting Teen Mothers' Mental Health.

    Science.gov (United States)

    Freed, Patricia; SmithBattle, Lee

    2016-01-01

    In this second article in a two-part series, we call for the integration of strengths-based and trauma-informed care into services for teen mothers. Nurses working with teen mothers in health clinics, schools and home visiting programs can play a pivotal role in promoting their mental health. Many teen mothers have high levels of psychological distress and histories of adverse experiences that cannot be ignored, and cannot solely be addressed by referral to mental health services. Nurses must be prepared to assess for trauma and be open to listening to teen mothers' experiences. Principles of strengths-based and trauma-informed care are complementary and can be integrated in clinical services so that teen mothers' distress is addressed and their strengths and aspirations are supported. Potential screening tools, interviewing skills and basic strategies to alleviate teen mothers' distress are discussed.

  1. Do Child Care Subsidies Influence Single Mothers' Decision to Invest in Human Capital?

    Science.gov (United States)

    Herbst, Chris M.; Tekin, Erdal

    2011-01-01

    A child care subsidy is one of the most effective policy instruments to facilitate low-income individuals' transition from welfare to work. Although previous studies consistently find that subsidy receipt is associated with increased employment among single mothers, there is currently no evidence on the influence of these benefits on the decision…

  2. Health workers' views on quality of prevention of mother-to-child transmission and postnatal care for HIV-infected women and their children

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    Hardon Anita

    2009-05-01

    Full Text Available Abstract Background Prevention of mother-to-child transmission has been considered as not a simple intervention but a comprehensive set of interventions requiring capable health workers. Viet Nam's extensive health care system reaches the village level, but still HIV-infected mothers and children have received inadequate health care services for prevention of mother-to-child transmission. We report here the health workers' perceptions on factors that lead to their failure to give good quality prevention of mother-to-child transmission services. Methods Semistructured interviews with 53 health workers and unstructured observations in nine health facilities in Hanoi were conducted. Selection of respondents was based on their function, position and experience in the development or implementation of prevention of mother-to-child transmission policies/programmes. Results Factors that lead to health workers' failure to give good quality services for prevention of mother-to-child transmission include their own fear of HIV infection; lack of knowledge on HIV and counselling skills; or high workloads and lack of staff; unavailability of HIV testing at commune level; shortage of antiretroviral drugs; and lack of operational guidelines. A negative attitude during counselling and provision of care, treating in a separate area and avoidance of providing service at all were seen by health workers as the result of fear of being infected, as well as distrust towards almost all HIV-infected patients because of the prevailing association with antisocial behaviours. Additionally, the fragmentation of the health care system into specialized vertical pillars, including a vertical programme for HIV/AIDS, is a major obstacle to providing a continuum of care. Conclusion Many hospital staff were not being able to provide good care or were even unwilling to provide appropriate care for HIV-positive pregnant women The study suggests that the quality of prevention of

  3. Caring for the infant of a diabetic mother.

    Science.gov (United States)

    Hatfield, Linda; Schwoebel, Ann; Lynyak, Corinne

    2011-01-01

    In the United States, approximately 100,000 infants are born to diabetic mothers each year. If diabetes in pregnancy is uncontrolled, the diversity of resulting health problems can have a profound effect on the embryo, the fetus, and the neonate. These infants are at risk for a multitude of physiologic, metabolic, and congenital complications such as macrosomia, asphyxia, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, polycythemia and hyperviscosity, cardiomegaly, and central nervous system disruption. Preconception control of glucose metabolism throughout the trajectory of a woman's pregnancy is a significant factor in decreasing the adverse impact of diabetes on the fetus and newborn. Meticulous attention to neonatal glucose levels, thorough physical examination, and precise diagnosis are prerequisites to appropriate care for the neonate.

  4. Cancer Care at Times of Crisis and War: The Syrian Example.

    Science.gov (United States)

    Sahloul, Eman; Salem, Riad; Alrez, Wessam; Alkarim, Tayseer; Sukari, Ammar; Maziak, Wasim; Atassi, M Bassel

    2017-08-01

    As Syria enters its fifth year of conflict, the number of civilians killed and injured continues to rise sharply. Along with this conflict comes the rapid decline of medical care, specifically cancer care. To determine physician and equipment availability, cancer screening and management, and possible solutions relative to various major cities, a survey was distributed to physicians inside Syria through the help of the humanitarian organization Syrian American Medical Society. Online surveys were distributed to both certified oncologists who work in cancer clinics and general physicians who work in rural and mobile clinics inside Syria. Variables assessed were physician specialty, location, population, cost, regional situation (besieged versus government controlled), and resource availability and access. Results were stratified by location and physician specialty. Survey results revealed a large shortage of specialized physicians and inhibited accessibility to screening and management options in besieged areas compared with government-controlled regions. Physicians within both government-controlled and besieged cities reported limited or no targeted agents, radiation therapy, clinical trials, bone marrow transplantation, positron emission tomography scans, magnetic resonance imaging, and genetic testing. The Syrian civil war has resulted in suboptimal oncology care in the majority of the region. In consideration of specific deficiencies in cancer care, we recommend several solutions that may better the level of care in Syria: patient education on medical documentation and self-examination; online consultation; and cheap, effective screening methods. The implementation of these recommendations may change the course of cancer care in a country that has deteriorated into the worst humanitarian crisis of the century.

  5. Cancer Care at Times of Crisis and War: The Syrian Example

    Directory of Open Access Journals (Sweden)

    Eman Sahloul

    2017-08-01

    Full Text Available Purpose: As Syria enters its fifth year of conflict, the number of civilians killed and injured continues to rise sharply. Along with this conflict comes the rapid decline of medical care, specifically cancer care. To determine physician and equipment availability, cancer screening and management, and possible solutions relative to various major cities, a survey was distributed to physicians inside Syria through the help of the humanitarian organization Syrian American Medical Society. Methods: Online surveys were distributed to both certified oncologists who work in cancer clinics and general physicians who work in rural and mobile clinics inside Syria. Variables assessed were physician specialty, location, population, cost, regional situation (besieged versus government controlled, and resource availability and access. Results were stratified by location and physician specialty. Results: Survey results revealed a large shortage of specialized physicians and inhibited accessibility to screening and management options in besieged areas compared with government-controlled regions. Physicians within both government-controlled and besieged cities reported limited or no targeted agents, radiation therapy, clinical trials, bone marrow transplantation, positron emission tomography scans, magnetic resonance imaging, and genetic testing. Conclusion: The Syrian civil war has resulted in suboptimal oncology care in the majority of the region. In consideration of specific deficiencies in cancer care, we recommend several solutions that may better the level of care in Syria: patient education on medical documentation and self-examination; online consultation; and cheap, effective screening methods. The implementation of these recommendations may change the course of cancer care in a country that has deteriorated into the worst humanitarian crisis of the century.

  6. Stillbirth: the mother's experience and implications for improving care.

    Science.gov (United States)

    Cacciatore, Joanne; Bushfield, Suzanne

    2007-01-01

    More children die as a result of stillbirth than all other causes of infant deaths combined (Ananth, Shiliang, Kinzler, and Kramer, 2005; Goldenberg, Kirby, and Culhane, 2004; Froen, 2005; National Institute of Health, 2004); yet, mothers experiencing stillbirth are often left without support afterwards (Kubler-Ross, 2004; Fahey-McCarthy, 2003; Fletcher 2002; Saddler, 1987; DeFrain, 1986; Kirkley-Best & Kellner, 1982). Despite social work's growing involvement in care at the end of life, parents of stillborn children have not experienced consistent, relevant, and competent professional care in coping with the tragedy of death. Forty-seven women between the ages of 19 and 51 were recruited through nonprofit agencies that provide bereavement care to grieving families. Results of this qualitative study suggest that stillbirth is emotionally complex with long-lasting symptoms of grief and significant struggles to find meaning. The findings also support the need for perceived psychosocial and spiritual support from professional caregivers, family, and friends. The women's own experiences argue for comprehensive approaches to support the grief and loss of stillbirth, and for the importance of social work involvement in both immediate and longer term interventions.

  7. Crisis intervention for people with severe mental illnesses.

    Science.gov (United States)

    Murphy, Suzanne M; Irving, Claire B; Adams, Clive E; Waqar, Muhammad

    2015-12-03

    A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis-intervention models of care were developed as a possible solution. To review the effects of crisis-intervention models for anyone with serious mental illness experiencing an acute episode compared to the standard care they would normally receive. If possible, to compare the effects of mobile crisis teams visiting patients' homes with crisis units based in home-like residential houses. We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials. There is no language, time, document type, or publication status limitations for inclusion of records in the register. This search was undertaken in 1998 and then updated 2003, 2006, 2010 and September 29, 2014. We included all randomised controlled trials of crisis-intervention models versus standard care for people with severe mental illnesses that met our inclusion criteria. We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assessed risk of bias for included studies and used GRADE to create a 'Summary of findings' table. The update search September 2014 found no further new studies for inclusion, the number of studies included in this review remains eight with a total of 1144 participants. Our main outcomes of interest are hospital use, global state, mental state, quality of life, participant satisfaction and family burden. With the exception of mental state, it was not possible to pool data for these outcomes.Crisis intervention may reduce repeat admissions to hospital (excluding index admissions) at six months (1 RCT, n = 369, RR 0.75 CI 0.50 to 1.13, high quality evidence), but does appear to reduce family burden (at six months: 1 RCT, n = 120, RR 0.34 CI 0.20 to 0.59, low quality evidence), improve

  8. The myasthenic patient in crisis: an update of the management in Neurointensive Care Unit

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    Daniel Agustin Godoy

    2013-09-01

    Full Text Available Myasthenia gravis (MG is an autoimmune disorder affecting neuromuscular transmission leading to generalized or localized muscle weakness due most frequently to the presence of autoantibodies against acetylcholine receptors in the postsynaptic motor end-plate. Myasthenic crisis (MC is a complication of MG characterized by worsening muscle weakness, resulting in respiratory failure that requires intubation and mechanical ventilation. It also includes postsurgical patients, in whom exacerbation of muscle weakness from MG causes a delay in extubation. MC is a very important, serious, and reversible neurological emergency that affects 20–30% of the myasthenic patients, usually within the first year of illness and maybe the debut form of the disease. Most patients have a predisposing factor that triggers the crisis, generally an infection of the respiratory tract. Immunoglobulins, plasma exchange, and steroids are the cornerstones of immunotherapy. Today with the modern neurocritical care, mortality rate of MC is less than 5%.

  9. Teaching Method in Situational Crisis Communication Theory: A Literature Review

    OpenAIRE

    Proud Arunrangsiwed

    2016-01-01

    Crisis management strategies could be found in various curriculums, not only in schools of business, but also schools of communication. Young students, such as freshmen and sophomores of undergraduate schools, may not care about learning crisis management strategies. Moreover, crisis management strategies are not a topic art students are familiar with. The current paper discusses a way to adapt entertainment media into a crisis management lesson, and the importance of learning crisis manageme...

  10. Pilot Study: Mother's Attitude and Practices toward Antenatal Care, Micronutrient Supplementation and Breastfeeding in Salmaniya Medical Complex

    International Nuclear Information System (INIS)

    Husain, Dana

    2014-01-01

    Full text: Good nutrition in the first 1000 days provides a stable long term foundation for society, as it ensures a child's growth to his/her potential (1). Pregnant women who suffer from multiple micronutrient deficiencies have been associated with poor pregnancy outcomes including Low Birth weight-LBW (4). Iron deficiency anemia is linked to an increased risk of infections (4), and is still a health problem in the kingdom of Bahrain with the prevalence of 22.7% to 54% (5). The World Health Organization (WHO), United Nation Children's fund (UNICEF) and American Academy of Pediatrics recommendations are to initiate breastfeeding within the first hour of life and to and sustain exclusive breastfeeding for 6 months (6). Several studies have shown a downward trend of breastfeeding in developing countries such as Kingdom of Saudi Arabia (7,8). Studies in Kingdom of Saudi Arabia and Kingdom of Bahrain have shown partial breastfeeding at early months<6month age (8,9) Aim: To provide a preliminary evaluation of the mother's attitude/practices toward antenatal care, micronutrient supplementation and breastfeeding in Salmaniya Medical Complex (SMC), Kingdom of Bahrain. Methods: A sample of 62 Bahraini mothers - inpatients and outpatients- within the age group of 20 years to 35 years old at SMC were asked by dietitians and diet technicians to answer 7 closed ended questions about importance of antenatal care, compliance to nutritional recommendations during pregnancy and breastfeeding practices. Statistical Package for Social Science (SPSS) was used in analyzing data collected. Fisher Exact test and Chi-Square test were used to correlate the determinants (age and education level) with mother's attitude/practices. Statistical significance was assumed at p<0.05 Results: Scores showed no significant correlation between education level mother's attitude/practices toward antenatal care, micronutrient supplementation and breastfeeding. As for age, we found more mothers above 25

  11. Critical views on postpartum care expressed by new mothers

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    Waldenström Ulla

    2007-11-01

    Full Text Available Abstract Background Women's evaluation of hospital postpartum care has consistently been more negative than their assessment of other types of maternity care. The need to further explore what is wrong with postpartum care, in order to stimulate changes and improvements, has been stressed. The principal aim of this study was to describe women's negative experiences of hospital postpartum care, expressed in their own words. Characteristics of the women who spontaneously gave negative comments about postpartum care were compared with those who did not. Methods Data were taken from a population-based prospective longitudinal study of 2783 Swedish-speaking women surveyed at three time points: in early pregnancy, at two months, and at one year postpartum. At the end of the two follow-up questionnaires, women were asked to add any comment they wished. Content analysis of their statements was performed. Results Altogether 150 women gave negative comments about postpartum care, and this sample was largely representative of the total population-based cohort. The women gave a diverse and detailed description of their experiences, for instance about lack of opportunity to rest and recover, difficulty in getting individualised information and breastfeeding support, and appropriate symptom management. The different statements were summarised in six categories: organisation and environment, staff attitudes and behaviour, breastfeeding support, information, the role of the father and attention to the mother. Conclusion The findings of this study underline the need to further discuss and specify the aims of postpartum care. The challenge of providing high-quality follow-up after childbirth is discussed in the light of a development characterised by a continuous reduction in the length of hospital stay, in combination with increasing public demands for information and individualised care.

  12. [Gestational history and prenatal care characteristics of adolescent and adult mothers in a maternity hospital in the interior of Minas Gerais, Brazil].

    Science.gov (United States)

    Santos, Luciana Angélica Vieira; Lara, Maristela Oliveira; Lima, Renata Caroline Ribeiro; Rocha, André Freire; Rocha, Euza Mara; Glória, José Cristiano Ramos; Ribeiro, Gabriela de Cássia

    2018-02-01

    The scope of this research was to analyze the gestational history and prenatal care characteristics of adolescent and adult mothers in a maternity hospital located in a city in Minas Gerais, which is a hospital of reference in the macro-region of health of Jequitinhonha. It involved a descriptive cross-sectional study. A total of 327 mothers were interviewed between May 2013 and March 2014 using a semi-structured questionnaire. With a sample of 255, the number of adult women was predominant. With respect to prenatal care, 324 pregnant women had medical appointments. In terms of the location for prenatal care, 79.2% of adolescents were attended in the public health service, while that percentage was 60.4% among adult women. Regarding the type of birth, 54.7% of mothers had normal delivery and 45% had cesarean section. Among adolescents, there was a higher percentage of normal delivery compared to adult women and this data had a statistically significant relationship with the age of the pregnant women. With respect to gestational age at birth, 85.9% had full-term deliveries, 13.5% had preterm delivery and 0.6% had post-term delivery. It was revealed that adolescent mothers were at a disadvantage compared to the other mothers in terms of both socioeconomic characteristics and prenatal care received.

  13. [An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group].

    Science.gov (United States)

    Kim, Dasom; Lee, Insook

    2017-10-01

    This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements. © 2017 Korean Society of Nursing Science

  14. Perceived Quality of Maternal Care in Childhood and Structure and Function of Mothers' Brain

    Science.gov (United States)

    Kim, Pilyoung; Leckman, James F.; Mayes, Linda C.; Newman, Michal-Ann; Feldman, Ruth; Swain, James E.

    2010-01-01

    Animal studies indicate that early maternal care has long-term effects on brain areas related to social attachment and parenting, whereas neglectful mothering is linked with heightened stress reactivity in the hippocampus across the lifespan. The present study explores the possibility, using magnetic resonance imaging, that perceived quality of…

  15. The role of crisis in family crisis intervention: do crisis experience and crisis change matter?

    NARCIS (Netherlands)

    Al, C.M.W.; Stams, G.J.J.M.; van der Laan, P.H.; Asscher, J.J.

    2011-01-01

    Evaluation studies of crisis intervention have focused on prevention of out-of-home placement of children or family functioning, but largely neglected the aspect of crisis. The present study examined crisis in 183 families receiving Family Crisis Intervention (FCI), addressing crisis characteristics

  16. District health care between quality assurance and crisis management. Possibilities within the limits, Mporokoso and Kaputa District, Zambia

    NARCIS (Netherlands)

    van Bergen, J. E.

    1995-01-01

    A tension exists between objectives of health policy makers to achieve high quality standards of care on one hand, and district multi-crisis reality in sub-Saharan Africa on the other hand where sheer survival of the (public) health system is questioned. The collapsing health services as well as the

  17. When caretaking competes with care giving: a qualitative study of full-time working mothers who are nurse managers.

    Science.gov (United States)

    Firmin, Michael W; Bailey, Megan

    2008-10-01

    The purpose of this study was to explore the motivations and stresses associated with full-time working mothers who practice as nurse managers. Full-time work outside the home for mothers has been recognized as a circumstance which may present certain benefits and risks to family life. Nursing management is recognized as a high-stress occupation, which may be filled by mothers who work full time. Little is known about the specific needs and stresses of full-time nurse managers who are caring for children at home. In-depth interviews were conducted with 13 mothers who worked as nurse managers. Participants expressed challenges in several areas including balancing/separating work and home, self-imposed advancement inhibitions, and constant giving. Challenges were offset by assets, which included complimentary roles, health insurance, added income, and professional and personal fulfilment. Participants 'wanted it all', including the conveniences of part-time employment and the benefits of full-time employment. Full-time nurse managers with children at home experience unique tensions which characterize their work and home environments. Employers may assist nurses by adopting flexible scheduling, educational and child-care support and assistance in negotiating work and home roles.

  18. THE INDEPENDENCE OF POST SECTIO CAESAREA MOTHER WITH DISCHARGE PLANNING BASED ON OREM'S SELF CARE THEORY

    Directory of Open Access Journals (Sweden)

    Tinok Ayu Putri W

    2017-04-01

    Full Text Available Introduction: Discharge planning is one of nursing intervention that aim to promote the independence of patient's self care-activities after discharge from hospital. This study was aimed to examine the effect of discharge planning on wound care independence of post sectio caesarea mother at Melati Room, Dr. Soegiri Hospital, Lamongan. Method: Design of this study was quasy experiment. The population were post sectio caesarea mother at Melati Room Dr. Soegiri Hospital Lamongan, since May – June 2012. The samples were taken by purposive sampling technique. Fourteen responsdents matched with the inclusion criteria and divided into treatment and control groups. The datas were collected by using questionnaire and observation sheet. Then datas were analyzed by using Wilcoxon Signed Rank Test and Mann Whitney U Test with significance level of α ≤ 0.05. Result: The result of this study showed that post sectio caesarea mother knowledge had significance level of p = 0.027 in treatment group, and in control group was p = 0.034, for post sectio caesarea patient's skill p = 0.015 in treatment group and in control group was p = 0.017. The result of Mann Whitney U test was p = 0.001, it means there was different in knowledge, and skill of wound care on post sectio caesarea patient between treatment and control groups. Discussion: It can be concluded that there are significant effect of wound care independence of post sectio caesarea patient with discharge planning approach based on orem's self care theory to improve patient's independence. Hospital need to develop discharge planning procedure to meet the needs of patient with post sectio caesarea wound and decrease the number of surgical wound infection.

  19. Children of imprisoned mothers.

    Science.gov (United States)

    Senanayake, M P; Arachchi, J K; Wickremasinghe, V P

    2001-06-01

    To describe the problems faced by children during separation from their imprisoned mothers, and evaluate the health of children who accompanied their mothers into prison. A prospective observational study. Welikada Prison, Colombo, Sri Lanka. 200 randomly selected mothers who had left their children at home were interviewed using a questionnaire. During a period of 8 months 30 children living with their mothers in prison underwent physical and developmental examination and tuberculin testing. The living conditions within the prison were evaluated. During 18 months from January 1999, 4089 women were imprisoned. 88% were remanded, 20% awaited trial for more than one year in prison. 2416 were mothers. 1411 had at least one child under 12 years of age. The 200 mothers interviewed had 262 children under 12 years at home. Their care arrangements were: a relative (69%), father (16%), older sibling (4%), religious organisation (2.7%), neighbour (1.3%). None had received social services support. 70 children accompanied mothers into prison. In the 30 children followed up regularly 23% had scabies, 10% pediculosis, and 7% impetigo. No severe malnutrition was found and screening for tuberculosis was negative. 70% were breastfed. The child-friendly dormitory was inadequate to accommodate all children. Care arrangements and schooling were affected and no counselling services were provided during the imprisoned mothers' absence. The children within the prison enjoyed close bonds with the mothers and their physical needs were met. The child's best interest had not always been considered by court when deciding on custody during the mothers' imprisonment.

  20. The crisis as catalyst for reframing health care policies in the European Union.

    Science.gov (United States)

    Helderman, Jan-Kees

    2015-01-01

    Seen from the perspective of health, the global financial crisis (GFC) may be conceived of as an exogenous factor that has undermined the fiscal sustainability of European welfare states and consequently, their (expanding) health systems as well. Being one of the core programs of European welfare states, health care has always belonged to the sovereignty of European Member States. However, in past two decades, European welfare states have in fact become semi-sovereign states and the European Union (EU) no longer is an exogenous actor in European health policy making. Today, the EU not only puts limits to unsustainable growth levels in health care spending, it also acts as an health policy agenda setter. Since the outbreak of the GFC, it does so in an increasingly coercive and persuasive way, claiming authority over health system reforms alongside the responsibilities of its Member States.

  1. Specialists without spirit: crisis in the nursing profession.

    Science.gov (United States)

    Hewa, S; Hetherington, R W

    1990-01-01

    This paper examines the crisis in the nursing profession in Western industrial societies in the light of Max Weber's theory of rationalisation. The domination of instrumental rational action in modern industrial societies in evident in the field of modern medicine. The burgeoning mechanistic approach to the human body and health makes modern health care services increasingly devoid of human values. Although the nursing profession has been influenced by various changes that took place in health care during the last few decades (for example greater reliance on technology), the underlying values of the nursing profession still emphasise a broad definition of the well-being of patients. Hence, in recent years the irrational consequences of growing technological medicine in North America has resulted in a serious crisis in the nursing profession. To resolve this crisis the authors propose a reorganisation of modern health care services on the basis of a new paradigm which is compatible with both the health care needs of the people and the main emphasis in education and training of the nursing profession. PMID:2287012

  2. Trial of Repeated Analgesia with Kangaroo Mother Care (TRAKC Trial)

    Science.gov (United States)

    2013-01-01

    Background Skin-to-skin contact (SSC) between mother and infant, commonly referred to as Kangaroo Mother Care (KMC), is recommended as an intervention for procedural pain. Evidence demonstrates its consistent efficacy in reducing pain for a single painful procedure. The purpose of this study is to examine the sustained efficacy of KMC, provided during all routine painful procedures for the duration of Neonatal Intensive Care Unit (NICU) hospitalization, in diminishing behavioral pain response in preterm neonates. The efficacy of KMC alone will be compared to standard care of 24% oral sucrose, as well as the combination of KMC and 24% oral sucrose. Methods/design Infants admitted to the NICU who are less than 36 6/7 weeks gestational age (according to early ultrasound), that are stable enough to be held in KMC, will be considered eligible (N = 258). Using a single-blinded randomized parallel group design, participants will be assigned to one of three possible interventions: 1) KMC, 2) combined KMC and sucrose, and 3) sucrose alone, when they undergo any routine painful procedure (heel lance, venipuncture, intravenous, oro/nasogastric insertion). The primary outcome is infant’s pain intensity, which will be assessed using the Premature Infant Pain Profile (PIPP). The secondary outcome will be maturity of neurobehavioral functioning, as measured by the Neurobehavioral Assessment of the Preterm Infant (NAPI). Gestational age, cumulative exposure to KMC provided during non-pain contexts, and maternal cortisol levels will be considered in the analysis. Clinical feasibility will be accounted for from nurse and maternal questionnaires. Discussion This will be the first study to examine the repeated use of KMC for managing procedural pain in preterm neonates. It is also the first to compare KMC to sucrose, or the interventions in combination, across time. Based on the theoretical framework of the brain opioid theory of attachment, it is expected that KMC will be a

  3. A Study of Crisis Management Based on Stakeholders Analysis Model

    Science.gov (United States)

    Qingchun, Yue

    2017-11-01

    From the view of stakeholder theory, not only the enterprises should provide services to shareholders, but also take care of the demands of stakeholders. Stakeholders for the enterprise crisis are the organizations and individuals, which cause crisis, respond to the crisis and affected by the enterprise crisis. In this paper, first of all, to comb the development of stakeholder theory systematically; secondly, with the help of the enterprise crisis stakeholder analysis model, analyze the concept of stakeholders for the enterprise crisis and membership, and with the example of Shuanghui Group for further analysis; finally, we put forward relevant proposals for the enterprise crisis from the view of stakeholders.

  4. [Being a mother: encounters between mothers of children with Duchenne muscular dystrophy and nurses in Taiwan].

    Science.gov (United States)

    Lee, Shu-Li; Chou, Fan-Hao; Chin, Chi-Chun

    2013-06-01

    The role of "mother" is understood and represented differently by people from different cultures. In traditional Taiwanese society, mothers demonstrate their existence value by giving birth to and raising sons able to continue her husband's familial line. Sons bear the patriarchal name and care for their parents in old age. However, a son stricken, paralyzed and eventually killed by Duchenne muscular dystrophy (DMD) can destroy a mother's perceived value in this traditional social context. Mothers are thus soundless sufferers. Nurses have a critical role to play in giving encouragement and hope to mothers of children with DMD. Through their own difficult situation, these mothers can also highlight the value and importance of Taiwan's nurses, who work in conditions marked by overloading, high stress, and under-appreciation. Caring for women in critical need of empathy and support help nurses realize their own positive capacity to empower sufferers.

  5. [Families of the economic crisis in paediatric Primary Care clinics: descriptive observational study].

    Science.gov (United States)

    Martín Martín, R; Sánchez Bayle, M; Gancedo García, C; Teruel de Francisco, M C; Coullaut López, A

    2016-04-01

    To study the impact of the economic crisis on the families of the children who attend Primary Health Care and its relationship with their socioeconomic status. Observational descriptive study was conducted by analysing the results of 453 questionnaires, given to the parents of children between 1 and 7 years old who attended 4 paediatric clinics in Madrid. The raw data was analysed, and comparisons between groups and multivariate analysis were performed. In the multivariate analysis, the variables related to the non-acquisition of prescribed medication are: lower income level OR=0.118, p<.0001 and lower educational level OR=0.464, p<.001; the variables related to the reduction of food expenditure are: lower income level OR=0.100, p<.0001 and a higher number of family members OR=1.308, p=.045; the variables related to anti-pneumococcal vaccination without public funding are: higher income level OR=2.170, p=.0001, higher educational level OR=1.835, p=.013, and not being an immigrant OR=0.532, p=.037. The presence of health problems from the beginning of the economic crisis is related to unemployment OR=4.079, p=.032, lower educational level R=0.678, p=.042, and income level OR=0.342, p<.0001. In all cases, the models achieved a statistical significance of p<.0001. The economic crisis has greater impact on the group with the lowest income level in all analysed variables. The lower educational level and higher number of family members has an impact on the reduction in food expenditure. The fact of being an immigrant has an impact on not receiving the anti-pneumococcal and rotavirus vaccination. Unemployment leads to an increase in health problems in the family. To sum up, the economic crisis has increased inequalities according to socioeconomic status. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  6. The influence of intrafamilial power on maternal health care in Mali: perspectives of women, men and mothers-in-law.

    Science.gov (United States)

    White, Darcy; Dynes, Michelle; Rubardt, Marcie; Sissoko, Koman; Stephenson, Rob

    2013-06-01

    Evidence from diverse settings suggests that women often have limited control over their own reproductive health decisions. To increase uptake of preventive services and behaviors, it is important to understand how intrafamilial power dynamics and the attitudes of women, their husband and their mother-in-law are associated with maternal health practices. In 317 households in two rural districts of central Mali, women who had given birth in the previous year, their husband and their mother-in-law each completed a survey gauging their attitudes toward constructs of gender, power and health. Bivariate and multivariable logistic regression analyses were conducted to identify associations with four maternal health outcomes: antenatal care frequency, antenatal care timing, institutional delivery and postnatal care. In multivariable analyses, the preferences and opinions of mothers-in-law were associated with the maternal health behaviors of their daughters-in-law. Women's own perceptions of their self-efficacy, the value of women in society and the quality of services at the local health facility were also independently associated with their preventive and health-seeking practices. Husbands' preferences and opinions were not associated with any outcome. Interventions focusing on women or couples may be insufficient to advance women's reproductive health in patriarchal societies such as Mali. Future research and programmatic efforts need to address gender norms and consider the influence of other family members, such as mothers-in-law.

  7. Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring.

    Science.gov (United States)

    Lay, Barbara; Salize, Hans Joachim; Dressing, Harald; Rüsch, Nicolas; Schönenberger, Thekla; Bühlmann, Monika; Bleiker, Marco; Lengler, Silke; Korinth, Lena; Rössler, Wulf

    2012-09-05

    The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients' perceived coercion and to increase patient satisfaction, their quality of life and empowerment. This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care procedures (control group

  8. Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring

    Directory of Open Access Journals (Sweden)

    Lay Barbara

    2012-09-01

    Full Text Available Abstract Background The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients’ perceived coercion and to increase patient satisfaction, their quality of life and empowerment. Methods/Design This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be

  9. Double deprivation: a phenomenological study into the experience of being a carer during a mental health crisis.

    Science.gov (United States)

    Albert, Rikke; Simpson, Alan

    2015-12-01

    To explore carers' experience of caring during a mental health crisis. Community mental health care including crisis care relies increasingly on carers. The relationship between carers and professionals is at times fraught due to issues of what constitutes a crisis, confidentiality and a perception of lack of empathy. The caring experience can lead carers to feel isolated and neglected. A qualitative study with a phenomenological approach. Eight carers participated and were interviewed individually using a semi-structured approach. Analysis used the Interpretive Phenomenological Analysis method including transcribing of interviews, initial noting, searching for connections and patterns across the transcripts and cases. The themes were checked with the participants for their views on the emerging themes. The data were collected from November 2011-May 2012. Carers experienced 'double deprivation' by not receiving support from professionals and protecting their social network from the trauma of the crisis. The caring in crisis invoked complex feelings of guilt and loyalty which made discussing aggression difficult. Caring was described as a terrifying experience not just because of the aggression but also because of the perception of abandonment by professionals. The experience was an overwhelmingly negative one with a wish for acknowledgement of the crisis and support from mental health services. For most of the participants the caring during crisis was traumatic which left the carer feeling isolated and unsupported. The study should be used to help educate professionals on the complexities of caring during a crisis. © 2015 John Wiley & Sons Ltd.

  10. [Levels of state-trait anxiety between mothers and fathers who have children in an intensive care unit.

    Science.gov (United States)

    Rojas-Carrasco, Karmina Elena

    2013-01-01

    Background: when there is a child patient in the family, it is frequent that parents get upset. Anxiety in the mother and father could be different depending on the way each one lives the critical situation of the child patient. The purpose was to measure levels of anxiety in fathers and mothers who had a hospitalized child in an intensive care unit. Methods: the State-Trait Anxiety Inventory (STAI) was applied to a group of 50 pairs of parents who had a hospitalized child in the intensive care unit in a pediatric hospital. A no probabilistic intentional sample was used. Differences between groups were analyzed by Student's t test. Results: no significant differences were obtained between mothers and fathers for both state-anxiety and trait-anxiety. Significant differences were obtained intra-groups between both kinds of anxiety. Conclusions: having a child who is chronically sick or hospitalized for intensive therapy causes similar levels of anxiety in both parents. Anxiety is significantly increased in both parents when their child is hospitalized in an intensive therapy unit.

  11. The impact of caring for children with mental retardation on families as perceived by mothers in Karachi, Pakistan

    International Nuclear Information System (INIS)

    Lakhani, A.; Gavino, I.; Yousafzai, A

    2013-01-01

    Objective: To assess how families perceive the positive and negative impacts of caring for a child with mental retardation. Methods: The quantitative descriptive study was conducted from January to August 2007 and comprised 54 families attending a private day-care centre for children with special needs in Karachi, Pakistan. The Kansas Inventory of Parental Perceptions was used to assess mothers' perceptions on the impact of caring for a child with mental retardation. Positive contributions, social comparisons with others, understanding of disability and perception of control were assessed. SPSS 16 was used for statistical analysis. Results: Mothers reported positive contribution to family life as a result of caring for a child with mental retardation (Mean: 2.95+-0.37). There was an acceptance of the situation and a trend towards upward favourable comparison with other families (Mean: 3.13+-0.07). Conclusions: Contrary to earlier studies exploring the impact of caring for a child with disabilities having largely focused on negative contributions, the study highlights some positive contributions. (author)

  12. The impact of the global economic crisis on HIV and AIDS ...

    African Journals Online (AJOL)

    This investigation sought to ascertain the extent to which the global economic crisis of 2008–2009 affected the delivery of HIV/AIDS-related services directed at pregnant and lactating mothers, children living with HIV and children orphaned through HIV in Zambia. Using a combined macroeconomic analysis and a multiple ...

  13. 76 FR 27601 - Mother's Day, 2011

    Science.gov (United States)

    2011-05-11

    ... and elder care, and education. My budget strengthens the Child and Dependent Care Tax Credit to help..., so have the challenges facing women raising families. Many American women are raising children at... extraordinary importance of mothers in our lives. The bond of love and dedication a mother shares with her...

  14. Physical and mental health of mothers caring for a child with Rett syndrome.

    Science.gov (United States)

    Laurvick, Crystal L; Msall, Michael E; Silburn, Sven; Bower, Carol; de Klerk, Nicholas; Leonard, Helen

    2006-10-01

    Our goal was to investigate the physical and mental health of mothers who care for a child with Rett syndrome. We assessed maternal physical and mental health by using the SF-12 version 1 physical component summary and mental component summary scores as the outcome measures of interest. Mothers (n = 135) of children with Rett syndrome completed the SF-12 measure as part of the Australian Rett Syndrome Study in 2002. The analysis investigated linear relationships between physical and mental health scores and maternal, family, and child characteristics. Mothers ranged in age from 21 to 60 years and their children from 3 to 27 years. Nearly half of these mothers (47.4%) indicated that they worked full-time or part-time outside the home, and 41% had a combined family (gross) income of health demonstrated that the following factors were positively associated with better maternal physical health: the mother working full-time or part-time outside the home, having some high school education, having private health insurance, the child not having breathing problems in the last 2 years, the child not having home-based structured therapy, and high scores on the Family Resource Scale (indicating adequacy of time resources for basic and family needs). The resultant model for mental health demonstrated that the following factors were positively associated with better maternal mental health: the mother working full-time or part-time outside the home, the child not having a fracture in the last 2 years, lesser reporting of facial stereotypes and involuntary facial movements, being in a well-adjusted marriage, and having low stress scores. Our study suggests that the most important predictors of maternal physical and emotional health are child behavior, caregiver demands, and family function.

  15. When it is costly to have a caring mother: food limitation erases the benefits of parental care in earwigs.

    Science.gov (United States)

    Meunier, Joël; Kölliker, Mathias

    2012-08-23

    The aggregation of parents with offspring is generally associated with different forms of care that improve offspring survival at potential costs to parents. Under poor environments, the limited amount of resources available can increase the level of competition among family members and consequently lead to adaptive changes in parental investment. However, it remains unclear as to what extent such changes modify offspring fitness, particularly when offspring can survive without parents such as in the European earwig, Forficula auricularia. Here, we show that under food restriction, earwig maternal presence decreased offspring survival until adulthood by 43 per cent. This effect was independent of sibling competition and was expressed after separation from the female, indicating lasting detrimental effects. The reduced benefits of maternal presence on offspring survival were not associated with higher investment in future reproduction, suggesting a condition-dependent effect of food restriction on mothers and local mother-offspring competition for food. Overall, these findings demonstrate for the first time a long-term negative effect of maternal presence on offspring survival in a species with maternal care, and highlight the importance of food availability in the early evolution of family life.

  16. Exploring the use of mothers' own milk as oral care for mechanically ventilated very low-birth-weight preterm infants.

    Science.gov (United States)

    Thibeau, Shelley; Boudreaux, Cynthia

    2013-06-01

    The purpose of this study was to explore the use of mothers' own milk (colostrums, transitional milk, and mature milk) as oral care in the ventilator-associated pneumonia (VAP)-prevention bundle of mechanically ventilated preterm infants weighing 1500 g or less. Mechanically ventilated preterm infants weighing 1500 g or less admitted to a regional level III NICU in the Gulf South between January 1, 2006, and December 31, 2009. Retrospective descriptive. Oral care with mothers' own milk was implemented as part of the VAP-prevention bundle in the neonatal intensive care unit in the fourth quarter of 2007. Using retrospective deidentified data retrieved from the electronic medical record, the primary and secondary outcome variables were collected among eligible infants (≤1500 g) admitted January 1, 2006, to December 31, 2007 (before implementation) and January 1, 2008, to December 31, 2009 (after implementation). Sample characteristics, including infant gestational age, birth weight, and gender, as well as maternal age, type of delivery, and incidence of maternal chorioamnionitis, were also collected. Data analysis included frequencies and distributions to summarize sample characteristics and variables of interest. Appropriate tests for differences were conducted on outcome variables between the before and after groups of the human milk oral care intervention. The feasibility outcome variable included nursing compliance with the oral care procedure. The safety outcome variable included record of any adverse events associated with the oral care procedure. The efficacy health outcomes included the rate of positive tracheal aspirates, positive blood cultures, the number of ventilator days, and length of stay. Infant age (26.1-26.6 weeks) and weight (840-863 g) were similar in the before (n = 70) and after (n = 68) sample subjects. There were no statistically significant differences in ventilator days, χ² (46, n = 115) = 46.22, P = .46, and length of stay, χ (75, n

  17. Bad Mothers and Monstrous Sons: Autistic Adults, Lifelong Dependency, and Sensationalized Narratives of Care.

    Science.gov (United States)

    Allen, Holly

    2017-03-01

    Sensationalized representations of autistic families in film and other media frequently feature violent encounters between mothers and sons. This essay analyzes two media stories and three films that suggest how limited-and therefore misleading-popular representations of the autism family are. Except for one of the films, these representations blame the problem of adult autistic dependency on either monstrous autism or bad mothering. Doing so elides collective social responsibility for autism care and denies the reality that autistic adults continue to have complex dependency needs that families cannot always meet. Narratives that sensationalize youth and adults with autism or scapegoat their maternal caregivers also diminish opportunities for social inclusion and for autistic people to live fully and dependently.

  18. The Effect of Kangaroo Mother Care on Neonatal Outcomes in Iranian Hospitals: A Review

    Directory of Open Access Journals (Sweden)

    Leila Sarparast

    2015-01-01

    Full Text Available Context: Kangaroo Mother Care (KMC is a supportive technique that beings at the neonatal period and is one of the skin-to-skin contact methods of holding neonate by mother. This method has an important role in exclusive breastfeeding and thermal care of neonates. This study aimed to investigate the application of KMC and evaluate the effect of this technique in different neonatal outcomes, particularly in Iranian neonates. Moreover, this review can be a tool for formative evaluation for this newly introduced treatment intervention in Iran. Evidence Acquisition: This review was conducted in national and international databases concerning experience with KMC on term and preterm neonates admitted in Iranian hospitals from 2006 to 2014. The measured outcomes included physiologic, psychologic, and clinical effects of this practice on newborn infants. Results: In this study, 42 Persian and English language papers were reviewed and finally 26 articles were selected. Various effects of KMC on different factors such as analgesia; physiological effects, breastfeeding, icterus, length of hospitalization, infection, psychologic effects, and weight gain were found. Conclusions: The results showed that as a simple and suitable strategy for increasing the health status of the mothers and newborns, KMC had an important role in improvement of neonatal outcomes in neonatal wards of Iranian hospitals in recent ten years. Therefore, promoting this technique in all neonatal wards of the country can promote health status of this population.

  19. Kangaroo care by fathers and mothers: comparison of physiological and stress responses in preterm infants.

    Science.gov (United States)

    Srinath, B K; Shah, J; Kumar, P; Shah, P S

    2016-05-01

    To compare physiological and biochemical responses in stable preterm neonates and their parents following kangaroo mother care (KMC) and kangaroo father care (KFC). We conducted a prospective cross-over design study of stable preterm neonates of KFC for 1 h on consecutive days in a random order. Heart rate, temperature, blood pressure, oxygen saturation and salivary cortisol in infants before and after kangaroo care and heart rate, temperature and salivary cortisol in parents before and after kangaroo care were measured. Pairwise comparisons of changes in these measures were analyzed. Twenty-six sets of neonates and their parents were studied for physiological parameters, of which 19 had adequate samples for salivary cortisol assessment. The infants had a mean birth weight of 1096 g (s.d.=217) and a mean postmenstrual age at study of 32 weeks (s.d.=2). There were no significant differences in the changes in mean heart rate (P=0.51), temperature (P=0.37), oxygen saturation (P=0.50), systolic blood pressure (P=0.32), mean blood pressure (0.10) and salivary cortisol (P=0.50) before and after KMC or KFC in the neonates. The changes in mean heart rate (P=0.62), temperature (P=0.28) and salivary cortisol (P=0.59) before and after kangaroo care were similar between mothers and fathers. No significant differences in physiological and stress responses were identified following KMC or KFC in preterm neonates. KFC may be as safe and as effective as KMC.

  20. Health care access and utilization among children of single working and nonworking mothers in the United States.

    Science.gov (United States)

    Clarke, Tainya C; Arheart, Kristopher L; Muennig, Peter; Fleming, Lora E; Caban-Martinez, Alberto J; Dietz, Noella; Lee, David J

    2011-01-01

    To examine indicators of health care access and utilization among children of working and nonworking single mothers in the United States, the authors used data on unmarried women participating in the 1997-2008 National Health Interview Survey who financially supported children under 18 years of age (n = 21,842). Stratified by maternal employment, the analyses assessed health care access and utilization for all children. Outcome variables included delayed care, unmet care, lack of prescription medication, no usual place of care, no well-child visit, and no doctor's visit. The analyses reveal that maternal employment status was not associated with health care access and utilization. The strongest predictors of low access/utilization included no health insurance and intermittent health insurance in the previous 12 months, relative to those with continuous private health insurance coverage (odds ratio ranges 3.2-13.5 and 1.3-10.3, respectively). Children with continuous public health insurance compared favorably with those having continuous private health insurance on three of six access/utilization indicators (odds ratio range 0.63-0.85). As these results show, health care access and utilization for the children of single mothers are not optimal. Passage of the U.S. Healthcare Reform Bill (HR 3590) will probably increase the number of children with health insurance and improve these indicators.

  1. A scoping review of crisis teams managing dementia in older people.

    Science.gov (United States)

    Streater, Amy; Coleston-Shields, Donna Maria; Yates, Jennifer; Stanyon, Miriam; Orrell, Martin

    2017-01-01

    Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1) conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2) conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice. For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis. The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8%) of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors. Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required to deliver a standardized care pathway and measurable intervention as part of a large-scale evaluation of effectiveness.

  2. Factors influencing prospective mother with prenatal qualified doctor care among the reproductive women in Bangladesh.

    Science.gov (United States)

    Kiser, Humayun; Nasrin, Tasmina

    2018-12-01

    Maternal and child mortality are the key indicators of health and development of the country. Maternal and child health are interconnected to prenatal care. Consulting a doctor at the prenatal stage will not only ensure mother's and her unborn babies' safety, but also has a great influence to reduce the maternal and infant mortality. In this paper, an attempt has been made to analyze the status of prenatal care provided by the qualified doctor among pregnant mothers in Bangladesh. Data and required information of 8793 reproductive women were collected from the Bangladesh Demographic and Health Survey (BDHS) 2014. Logistic regression model has been used to identify the most significant determinants of the prenatal doctor visits. In this research, it is found that prenatal cares by a qualified doctor during pregnancy depend on several social and demographic characteristics of a woman. It is observed that women staying both urban and rural areas have similar behaviour of caring regarding their pregnancy related complications. Beside this Respondent's age, education, her husband's education and the number of ever born children have significant contribution on prenatal doctor visit. On the other hand, division, religion, husband's desire for children has no effect on it. Overall the model is able to predict 71.65% women into their appropriate group based on these factors.

  3. Attitudes toward working mothers: accommodating the needs of mothers in the work force.

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    Albright, A

    1992-10-01

    More women, including mothers, are part of the work force than ever before. In the workplace, barriers often exist that restrict promotion and advancement of mothers. Mothers often are penalized in attempting to meet the demands of parent and worker roles. Parenting practices have been considered primarily the domain of mothers. However, nurturing may be done effectively by fathers or other motivated adults. Policies of employers must change to accommodate needs of families. Examples of supportive practices may include flexible working hours, parental leave, and on-site child care.

  4. CAN MOTHERS CARE FOR ACUTE DIARRHOEAL DISEASE OF THEIR UNDER FIVE CHILDREN EFFECTIVELY AT HOME? A CROSS SECTIONAL STUDY IN SLUM COMMUNITY IN BANKURA

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    Eashin

    2015-09-01

    Full Text Available BACKGROUND : Diarrhea is one of the major causes of morbidity and mortality in under - five children in developing world like India. WHO & Integrated Management of Neonatal and Childhood Illness ( IMNCI diarrheal management guidelines encourage mothers and caretakers to treat diarrhoea at home by giving ORS and oral rehydration therapy (ORT to reduce the duration , severity , hospitalization , overall medical costs and death . OBJECTIVES : i t o assess the Knowledge , Attitude and Practice (KAP of mothers on home care of acu te diarrhoeal diseases and ii To find out the factors affecting it , if any. MATERIALS AND METHODS : Community based cross - sectional study was conducted for three months duration among 76 mothers of slum - dwelling under five children (2 - 59 months in Bankura . Information about KAP on management of acute diarrhoeal diseases was obtained by interview of mother using schedule based on WHO & IMNCI diarrheal management guidelines. RESULTS: In this study , majority mothers (64.7% of children were of BPL category an d mean schooling years of mothers was 7.97±4.12. Majority of mothers’ knowledge was average (66.2% and favourable attitude was (76.5%. While 72.2% mothers performed average practice ; only 9.3% of mothers performed good practice. Education , occupation and socio - economic status (SES were the influencing factors of KAP on home care of diarrhea. Conclusions : A lot of gap was still present in knowledge , attitude and practice of home management of acute diarrheal diseases in an urban slum of Bankura. Health pro viders are needed to be skilled , motivated to percolate the information to mothers regarding home care of diarrhea.

  5. Ebola Crisis in the United States

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    Avinash Raghunath Patwardhan M.D.

    2014-12-01

    Full Text Available This article is about readiness of the U.S. health care system to deal with crises. Using the Ebola crisis as a reference, first it examines the response to the current challenge. However, that is the smaller objective of the article. Lately, we are also being challenged to deal with other kinds of epidemics like obesity, mental health diseases, and violence. These crises are not dramatic like the Ebola crisis. However, these are no less insidious than Ebola. If we are not ready for them, then these crises have the potential to undermine the long-term health and prosperity of our society. In this context, and therefore mainly, this article is about two major long-standing systemic problems in the U.S. health care system that the unfolding of the Ebola crisis has bared. One is about how the inherent problem in the design of American federalist system regarding state autonomy on health matters is creating a dysfunctional health care system. The other is about the inertia of the research industry in the health care system in clinging to an archaic outdated inefficient mind-set and methodology that fails to generate the right information required for an appropriate decision making in matters of health care delivery, including crises. These problems are not small, nor their solutions easy. However, no matter how uncomfortable and tedious, facing them is necessary and inevitable. The discussions and arguments in this article are to outline their nature broadly and to make a call to further a dialogue.

  6. Management of myasthenic crisis in a child.

    Science.gov (United States)

    Rybojad, Beata; Lesiuk, Witold; Fijałkowska, Anna; Rybojad, Paweł; Sawicki, Marek; Lesiuk, Leszek

    2013-01-01

    Myasthenia gravis is an autoimmune disorder of peripheral nervous system, leading to fluctuating muscle weakness. It is caused by circulating antibodies that block acetylcholine nicotinic postsynaptic receptors at the postsynaptic neuromuscular junction. Myasthenic crisis is a life-threatening complication, which is defined as weakness from acquired myasthenia gravis. In this paper we described a 15-year-old boy who was admitted to the Paediatric Intensive Care Unit due to myasthenic crisis. He had suffered not only from myasthenia gravis but also hypothyroidism, cerebral palsy and epilepsy. The patient required mechanical ventilation and was successfully treated with both plasmapheresis and intravenous immunoglobulins. He recovered from the crisis and then thymectomy was performed. Perioperative period and anaesthesia passed uncomplicated. Discharged home from the hospital after 2.5 month-treatment, for the last 4 years, he has only come on scheduled outpatient medical appointments. This case reveals that myasthenic crisis, albeit rare, may occur in male adolescents. In such cases multidisciplinary care followed by surgery becomes a procedure of choice. Concomitant medical problems, if well controlled, do not affect the results of outcome of the underlying disease.

  7. Pilot trial of a parenting and self-care intervention for HIV-positive mothers: the IMAGE program.

    Science.gov (United States)

    Murphy, Debra A; Armistead, Lisa; Payne, Diana L; Marelich, William D; Herbeck, Diane M

    2017-01-01

    A pilot study was conducted to assess the effects of the IMAGE pilot intervention (Improving Mothers' parenting Abilities, Growth, and Effectiveness) on mothers living with HIV (MLH). Based on Fisher and Fisher's IMB model [1992. Changing AIDS risk behavior. Psychological Bulletin, 111, 455-474], the intervention focused on self-care and parenting behavior skills of MLH that affect maternal, child, and family outcomes. A randomized pre-test-post-test two-group design with repeated assessments was used. MLH (n = 62) and their children aged 6-14 (n = 62; total N = 124) were recruited for the trial and randomized to the theory-based skills training condition or a standard care control condition. Assessments were conducted at baseline with follow-ups at 3, 6, and 12 months. Maternal, child, and family outcomes were assessed. Results show significant effects of the intervention for improving parenting practices for mothers. The intervention also improved family outcomes, and showed improvements in the parent-child relationship. IMAGE had a positive impact on parenting behaviors, and on maternal, child, and family outcomes. Given MLH can be challenged by their illness and also live in under-resourced environments, IMAGE may be viewed as a viable way to improve quality of life and family outcomes.

  8. A scoping review of crisis teams managing dementia in older people

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    Streater A

    2017-10-01

    Full Text Available Amy Streater,1,2 Donna Maria Coleston-Shields,2 Jennifer Yates,2 Miriam Stanyon,2 Martin Orrell2 1Research and Development, North East London NHS Foundation Trust, Ilford, 2Institute of Mental Health, University of Nottingham, Nottingham, UK Background: Research on crisis teams for older adults with dementia is limited. This scoping review aimed to 1 conduct a systematic literature review reporting on the effectiveness of crisis interventions for older people with dementia and 2 conduct a scoping survey with dementia crisis teams mapping services across England to understand operational procedures and identify what is currently occurring in practice.Methods: For the systematic literature review, included studies were graded using the Critical Appraisal Skills Programme checklist. For the scoping survey, Trusts across England were contacted and relevant services were identified that work with people with dementia experiencing a mental health crisis.Results: The systematic literature review demonstrated limited evidence in support of crisis teams reducing the rate of hospital admissions, and despite the increase in number of studies, methodological limitations remain. For the scoping review, only half (51.8% of the teams had a care pathway to manage crises and the primary need for referral was behavioral or psychological factors.Conclusion: Evidence in the literature for the effectiveness of crisis teams for older adults with dementia remains limited. Being mainly cohort designs can make it difficult to evaluate the effectiveness of the intervention. In practice, it appears that the pathway for care managing crisis for people with dementia varies widely across services in England. There was a wide range of names given to the provision of teams managing crisis for people with dementia, which may reflect the differences in the setup and procedures of the service. To provide evidence on crisis intervention teams, a comprehensive protocol is required

  9. The mental health risks of economic crisis in Spain: evidence from primary care centres, 2006 and 2010.

    Science.gov (United States)

    Gili, Margalida; Roca, Miquel; Basu, Sanjay; McKee, Martin; Stuckler, David

    2013-02-01

    Nearly all European countries have been affected by the economic crisis that began in 2007, but the consequences have been among the worst in Spain. We investigated the associations of the recession on the frequency of mood, anxiety, somatoform, alcohol-related and eating disorders among those visiting Spanish primary care settings. Primary care physicians selected randomized samples of patients attending primary care centres representing Spain's consulting populations. A total of 7940 patients in 2006-07 and 5876 in 2010-11 were administered the Primary Care Evaluation of Mental Disorders (PRIME-MD) instrument to diagnose mental disorders. Multivariate logistic regression models were used to quantify overall changes in the frequency of mental disorders, adjusting for potential socio-demographic differences in consulting populations unrelated to economic factors. Compared with the pre-crisis period of 2006, the 2010 survey revealed substantial and significant increases in the proportion of patients with mood (19.4% in major depression), anxiety (8.4% in generalized anxiety disorder), somatoform (7.3%) and alcohol-related disorders (4.6% in alcohol dependence), all significant at P < 0.001, but not in eating disorders (0.15%, P = 0.172). Independent of observed risks of unemployment [odds ratio (OR) = 1.72, P < 0.001], we observed a significantly elevated risk of major depression associated with mortgage repayment difficulties (OR = 2.12, P < 0.001) and evictions (OR = 2.95, P < 0.001). About one-third of the overall risk in the consulting population's attendance with mental health disorders could be attributed to the combined risks of household unemployment and mortgage payment difficulties. Recession has significantly increased the frequency of mental health disorders and alcohol abuse among primary care attendees in Spain, particularly among families experiencing unemployment and mortgage payment difficulties.

  10. [Crisis and future of humanity].

    Science.gov (United States)

    Bellver Capella, Vicente

    2012-09-01

    We live in troubling times. The economic crisis fills us with anxiety. Young, unemployed and throes to finish living worse fear that their parents are not able to take charge of the situation. What has happened to that Spain and Europe, less than four years ago seemed to land of opportunities for native and foreign, have become hostile territories? The economic crisis does not explain everything; It is only a symptom that the basis on which we were building the future were not as firm. It is true that the crisis has brought to bare the obscenity of speculative financial capitalism. It is also true that this crisis can be the great opportunity to build the world on a human and sustainable economic basis, i.e.,just the opposite of the current submission to the dictatorship of the financial markets. But the contemporary crisis has deep and extensive roots. I will refer to other crises, as important or more than the economic one, because to glimpse the future it is essential to carefully track the present and discover the "weak signals" the latent opportunities that await we become them realities.

  11. Skin care practices in newborn nurseries and mother-baby units in Maryland.

    Science.gov (United States)

    Khalifian, S; Golden, W C; Cohen, B A

    2017-06-01

    Skin provides several important homeostatic functions to the developing neonate. However, no consensus guidelines exist in the United States for skin care in the healthy term newborn. We performed a study of skin and umbilical cord care (including bathing practices, vernix removal and antiseptic cord application) in newborn nurseries and mother-baby units throughout the state of Maryland to determine practices in a variety of clinical settings and assess if uniformity in skin care exists. These data were then assessed in the context of a review of the current literature. We received responses from over 90% of nurseries across the state. In our cohort, practices varied widely between institutions and specific populations, and often were not evidence-based or were contrary to best practices discussed in the scientific literature. The frequent departures from evidence that occur regarding the aforementioned practices are likely due to a lack of consensus on these issues as well as limited data on such practices, further highlighting the need for data-driven guidelines on newborn skin care.

  12. Qualitative Investigation of the Wellness Recovery Action Plan in a UK NHS Crisis Care Setting.

    Science.gov (United States)

    Ashman, Michael; Halliday, Vanessa; Cunnane, Joseph G

    2017-07-01

    Crisis theory suggests that in addition to presenting a threat to mental well-being, crises are also opportunities where successful interventions can lead to successful outcomes. UK mental health crisis teams aim to reduce hospital admission by treating people at home and by building resilience and supporting learning from crisis, yet data on repeat crisis episodes suggest this could be improved. This qualitative study sought to explore the Wellness Recovery Action Plan (WRAP) as a means of supporting resilience-building and maximising the opportunity potential of crisis. The following themes emerged: The meaning of crisis; Engaging with the WRAP process; WRAP and self-management; and Changes and transformations. This research suggests that WRAP has potential in supporting recovery from crisis, revealing insights into the nature of crisis which can inform the further development of crisis services.

  13. EFFECT OF KANGAROO MOTHER CARE ON OUTCOME IN PRETERM AND LOW BIRTH WEIGHT NEONATES

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    Chandra Sekhar Kondapalli

    2017-09-01

    Full Text Available BACKGROUND The aim of the study is to study the effect of kangaroo mother care(KMC on preterm and LBW neonates’ vital parameters like temperature, respiratory rate, heart rate and oxygen saturation, establishment of breastfeeding and weight gain, morbidity and mortality, outcome in intramural and extramural neonates. MATERIALS AND METHODS Hospital-based prospective study, Katuri Medical College and Hospital, 300 newborns shifted to KMC ward. In our study group, female newborns were more than male newborns. Inborn were more than outborn, late preterm more than early preterm and term neonates. A significant increase in axillary temperature, increase in respiratory rate, decrease in heart rate and increase in oxygen saturation was seen in neonates. Higher proportion of neonates achieved transition from predominant expressed breast milk consumption to predominant direct breastfeeding during hospital stay. RESULTS The study showed significantly mean weight gain per day during in hospital KMC of 20 g/kg/day. Mean age when neonates started to gain weight was 8.5 days. Neonates were discharged early as they met our discharge criteria with mean age being 11.6 days. Morbidity of neonates requiring NICU admissions apart from LBW in our study were hyperbilirubinaemia (49.9%, sepsis (19.4%, respiratory illness (7.8% and hypothermia (6.4%. During KMC stay, sepsis and NEC seen in 2 each, apnoea, PDA, jaundice in one each and maternal acceptance of KMC was good. During follow up, it was observed that all neonates were exclusively breastfed and the rate of weight gain (148 g/week was satisfactory with an exception that only 8 requiring hospitalisation and only 1 death due to severe infection. The response of the family and/or the father was supportive. CONCLUSION KMC sustains improvement in LBW neonates’ physiological parameters and accelerates growth pattern. Practice of KMC promote breastfeeding, shorten hospital stay without compromising survival, growth

  14. [Pre-pregnancy nutritional status, maternal weight gain, prenatal care, and adverse perinatal outcomes among adolescent mothers].

    Science.gov (United States)

    Santos, Marta Maria Antonieta de Souza; Baião, Mirian Ribeiro; de Barros, Denise Cavalcante; Pinto, Alessandra de Almeida; Pedrosa, Priscila La Marca; Saunders, Claudia

    2012-03-01

    To identify the association between pre-gestational nutritional status, maternal weight gain, and prenatal care with low birth weight (LBW) and prematurity outcomes in infants of adolescent mothers. Cross-sectional study with 542 pairs of adolescent mothers and their children attending a public maternity hospital in Rio de Janeiro. Data were collected from medical records. To determine the association between independent variables and the outcomes studied, odds ratio (OR) and a 95% confidence interval (CI) were estimated With respect to pre-pregnancy nutritional status of adolescents, 87% had normal weight, 1% were underweight, 10% were overweight, and 2% obese. Inadequate total gestational weight gain (72%) exceeded adequacy (28%). Birth weight was favored with greater gestational weight gain, and reduced with late onset of prenatal care. The comparison between the low birth weight and normal birth weight groups revealed significant differences between variable means: interval between the past pregnancy and current pregnancy (p = 0.022), pre-gestational weight (p = 0.018); pre-gestational body mass index (p pregnancy weight and body mass index before pregnancy. The minimum frequency of six prenatal care visits was a protective factor against LBW and prematurity.

  15. 'HTA for Crisis': sharing experiences during the 7th EBHC Symposium.

    Science.gov (United States)

    Wladysiuk, Magdalena; Tabor, Anna; Godman, Brian

    2013-02-01

    The Central and Eastern European Society of Technology Assessment in Health Care was founded in Krakow, Poland in 2003. On October 8th and 9th, the 7th symposium took place titled 'HTA for Crisis'. This meeting was attended by over 250 decision makers, evidence-based specialists, healthcare managers, commercial company personnel and experts. The symposium was principally divided into four main themes: insurance in times of crisis; importance of pricing of health services in times of crisis; managing welfare benefits in times of crisis and Health Technology Assessment in crisis-laden countries. The symposium finished by debating potential ways forward for healthcare systems in times of crisis.

  16. L’Italia: una crisi nella crisi.(Italy: A Crisis within the Crisis

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    Carlo D'ippoliti

    2011-10-01

    Full Text Available The article synthesises the large and extending literature on the financial and economic crisis from a Post-Keynesian point of view. The authors take on the position that the international and internal real imbalances are serious and worrying, but yet they are not the cause of the crisis or of its tremendous dimension. The flawed and insufficient regulation of finance is the prime cause of the crisis, as well as it is one of the main hindrances to expansionary macroeconomic policies that may less painfully drive developed countries out of the crisis. It then examines the most recent developments in the euro-area, claiming that we are not facing a sovereign debt crisis but rather a speculative attack on the euro. Finally, the article considers specifically the situation of Italy, currently at the hearth of such an attack, and suggests that the country was already facing critical developments before the 2007/2008 crisis. Thus, the policy measures so far suggested to exit the current stressful situation, in so far as they ignore this fact, seriously run the risk of proving insufficient or altogether noxious.JEL: B50; E12; G01  

  17. Use of antidepressants in the treatment of major depressive disorder in primary care during a period of economic crisis

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    Sicras-Mainar A

    2015-12-01

    Full Text Available Antoni Sicras-Mainar,1 Ruth Navarro-Artieda2 1Research Unit, Badalona Serveis Assistencials SA, 2Medical Documentation Unit, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain Objective: To describe antidepressant (AD use in the treatment of major depressive disorder during a period of economic crisis.Patients and methods: This was a retrospective, observational study using population-based databases. Two periods were considered: 1 2008–2009, precrisis, and 2 2012–2013, economic crisis. Certain inclusion/exclusion criteria were taken into account for the study (initiation of AD treatment. Patients were followed up for 12 months. The main measures were use (defined daily doses, epidemiologic measures, strategies used and treatment persistence, referrals, and use of resources. Statistical significance was set at P<0.05.Results: In the precrisis period, 3,662 patients were enrolled, and 5,722 were enrolled in the period of economic crisis. Average age was 58.8 years and 65.4% were women. Comparing the two periods, major depressive disorder prevalence was 5.4% vs 8.1%, P<0.001. During the period of economic crisis, AD use rose by 35.2% and drug expenditures decreased by 38.7%. Defined daily dose per patient per day was 10.0 mg vs 13.5 mg, respectively, P<0.001. At 12-month follow-up, the majority of patients (60.8% discontinued the treatment or continued on the same medication as before, and in 23.3% a change of AD was made.Conclusion: Primary health care professionals are highly involved in the management of the illness; in addition, during the period of economic crisis, patients with major depressive disorder showed higher rates of prevalence of the illness, with increased use of AD drugs. Keywords: consumption, antidepressants, economic crisis

  18. Intervention among Suicidal Men: Future Directions for Telephone Crisis Support Research.

    Science.gov (United States)

    Hunt, Tara; Wilson, Coralie J; Woodward, Alan; Caputi, Peter; Wilson, Ian

    2018-01-01

    Telephone crisis support is a confidential, accessible, and immediate service that is uniquely set up to reduce male suicide deaths through crisis intervention. However, research focusing on telephone crisis support with suicidal men is currently limited. To highlight the need to address service delivery for men experiencing suicidal crisis, this perspective article identifies key challenges facing current telephone crisis support research and proposes that understanding of the role of telephone crisis helplines in supporting suicidal men may be strengthened by careful examination of the context of telephone crisis support, together with the impact this has on help-provision for male suicidal callers. In particular, the impact of the time- and information-poor context of telephone crisis support on crisis-line staff's identification of, and response to, male callers with thoughts of suicide is examined. Future directions for research in the provision of telephone crisis support for suicidal men are discussed.

  19. Early Full-Time Day Care, Mother-Child Attachment, and Quality of the Home Environment in Chile: Preliminary Findings

    Science.gov (United States)

    Cárcamo, Rodrigo A.; Vermeer, Harriet J.; van der Veer, René; van IJzendoorn, Marinus H.

    2016-01-01

    Research Findings: Two longitudinal studies are reported examining the effects of full-time day care in Mapuche and non-Mapuche families in Chile. First, the Magellan-Leiden Childcare Study (MLCS) used a sample of 95 mothers with children younger than 1 year old (n = 36 in day care). Second, we partially cross-validated our results in a large and…

  20. Utilization of HIV testing services among pregnant mothers in low income primary care settings in northern Ethiopia: a cross sectional study.

    Science.gov (United States)

    Alemu, Yihun Mulugeta; Ambaw, Fentie; Wilder-Smith, Annelies

    2017-06-24

    HIV testing of women in child bearing age is an entry point for preventing mother-to-child transmission of HIV (MTCT). This study aims to identify the proportion of women tested for HIV and to determine factors associated with utilization of HIV testing services among pregnant mothers in primary care settings in northern Ethiopia. A cross sectional study was conducted in 416 pregnant women from four primary care centers between October 2, 2012 and May 31, 2013 in East Gojjam, Ethiopia. The proportion of mothers who tested for HIV was 277(67%). Among mothers who were not tested for HIV, lack of HIV risk perception (n = 68, 49%) was a major self-reported barrier for HIV testing. A multivariable logistic regression analysis showed that those pregnant women who had comprehensive knowledge about MTCT had an Adjusted Odd Ratio (AOR) of 3.73 (95% CI: 1.56, 8.94), having comprehensive knowledge on prevention of mother to child transmission (PMTCT) of HIV an AOR of 2.56 (95% CI: 1.26, 5.19), and a favorable attitude towards persons living with HIV an AOR of 2.42 (95%CI, 1.20, 4.86) were more likely to be tested for HIV. One third of pregnant women had never been tested for HIV until the time of the study. Efforts should be made to improve mother's knowledge about MTCT and PMTCT to increase uptake of HIV testing. Enhancing mother's HIV risk perception to scale up HIV testing in resource limited setting is highly recommended.

  1. Crisis, What Crisis? The Media: Business and Journalism in Times of Crisis

    Directory of Open Access Journals (Sweden)

    Rosario de Mateo

    2010-08-01

    Full Text Available The global financial and economic crisis is often used to justify a crisis of media and journalism: lower advertising, collapses in the share price, falls in consumption, more unemployment. But is this just a business crisis, or is it also a crisis in journalism and its role in democratic societies? In this case, is the journalism crisis attributable to the economic crisis or, rather, was it forged during the years of high profitability and high salaries in the mass media? These two sides of the crisis, in media industry and in journalism, are addressed in this article, which explores the evolution of mainly Spanish media in the years before the crisis. However, in order to understand how they reached the current situation, political and economic transformations in what has been called the Information Society and neoliberal globalization must be addressed.

  2. The efficiency of emerging Europe’s banking sector before and after the recent economic crisis

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    George Anayiotos

    2010-09-01

    Full Text Available This paper provides estimates for the relative efficiency of banks in emerging Europe before the recent boom, just before the crisis, and right after the crisis, using a Data Envelopment Analysis (DEA. The results suggest that DEA efficiency scores before the recent crisis were strongly linked to the host country’s level of development; were higher for foreign-owned banks; but did not stand out for bank groups with a presence in more than one country. The results also suggest that bank efficiency increased during the precrisis boom, but fell during the crisis. Finally, foreign-owned banks in emerging Europe seem to be less efficient than their mother banks, suggesting that although they may bring some efficiency benefits to their host country, they are highly affected by the local business and operational environment.

  3. Mothers going to war: the role of nurse practitioners in the care of military mothers and families during deployment.

    Science.gov (United States)

    Agazio, Janice; Hillier, Shannon L; Throop, Meryia; Goodman, Petra; Padden, Diane; Greiner, Shawna; Turner, Annette

    2013-05-01

    Many military women are being called to separate from their children to go to war. Most previous research has focused upon paternal, rather than, maternal, separation. The purpose of this article is to describe the experience of military mothers and their children during wartime deployments with clinical implications for nurse practitioners (NPs) in military or community settings. Using grounded theory methods, 37 active duty and reserve component military women participated in a one-time interview. Included were women who deployed for at least 4 months to Iraq or Afghanistan and had at least one child under the age of 12 during the separation. Military families present unique challenges for NPs. Mother deployments offer opportunities for intervention and anticipatory guidance across the trajectory of the separation. Military women's emotional and physical health must be supported before, during, and following deployment. NPs are ideally positioned to support military families. During deployment, the NP's focus may shift to care of the children and their caregiver. Before and at reintegration, NPs are in a key position to intervene early for posttraumatic stress and support family readjustment. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  4. Improving uptake and engagement with child body image interventions delivered to mothers: Understanding mother and daughter preferences for intervention content.

    Science.gov (United States)

    Garbett, Kirsty M; Diedrichs, Phillippa C

    2016-12-01

    Mothers are a key influence on adolescent girls' body image. This study aimed to improve understanding of mothers' and daughters' preferences for content in body image interventions designed to assist mothers to promote positive body image among their daughters. British mother-daughter dyads (N=190) viewed descriptions of five evidence-based influences on body image (family, friends, and relationships; appearance-based teasing; media and celebrities; appearance conversations; body acceptance and care). Mothers and daughters each selected the two most important influences to learn about in these interventions. Overall, both mothers and daughters most frequently opted for family, friends, and relationships and body acceptance and care, whereas media and celebrities was their least preferred topic. While the overall sample of mothers and daughters agreed on preferences, Fisher's exact tests showed that within-dyad agreement was low. Recommendations for improving parent and child engagement with, and effectiveness of, child body image interventions delivered to parents are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Deficient crisis-probing practices and taken-for-granted assumptions in health organisations

    Science.gov (United States)

    Canyon, Deon V.; Adhikari, Ashmita; Cordery, Thomas; Giguère-Simmonds, Philippe; Huang, Jessica; Nguyen, Helen; Watson, Michael; Yang, Daniel

    2011-01-01

    The practice of crisis-probing in proactive organisations involves meticulous and sustained investigation into operational processes and management structures for potential weaknesses and flaws before they become difficult to resolve. In health organisations, crisis probing is a necessary part of preparing to manage emerging health threats. This study examined the degree of pre-emptive probing in health organisations and the type of crisis training provided to determine whether or not they are prepared in this area. This evidence-based study draws on cross-sectional responses provided by executives from chiropractic, physiotherapy, and podiatry practices; dental and medical clinics; pharmacies; aged care facilities; and hospitals. The data show a marked lack of mandatory probing and a generalised failure to reward crisis reporting. Crisis prevention training is poor in all organisations except hospitals and aged care facilities where it occurs at an adequate frequency. However this training focuses primarily on natural disasters, fails to address most other crisis types, is mostly reactive and not designed to probe for and uncover key taken-for-granted assumptions. Crisis-probing in health organisations is inadequate, and improvements in this area may well translate into measurable improvements in preparedness and response outcomes. PMID:24149030

  6. Deficient crisis-probing practices and taken-for-granted assumptions in health organisations.

    Science.gov (United States)

    Canyon, Deon V; Adhikari, Ashmita; Cordery, Thomas; Giguère-Simmonds, Philippe; Huang, Jessica; Nguyen, Helen; Watson, Michael; Yang, Daniel

    2011-04-18

    The practice of crisis-probing in proactive organisations involves meticulous and sustained investigation into operational processes and management structures for potential weaknesses and flaws before they become difficult to resolve. In health organisations, crisis probing is a necessary part of preparing to manage emerging health threats. This study examined the degree of pre-emptive probing in health organisations and the type of crisis training provided to determine whether or not they are prepared in this area. This evidence-based study draws on cross-sectional responses provided by executives from chiropractic, physiotherapy, and podiatry practices; dental and medical clinics; pharmacies; aged care facilities; and hospitals. The data show a marked lack of mandatory probing and a generalised failure to reward crisis reporting. Crisis prevention training is poor in all organisations except hospitals and aged care facilities where it occurs at an adequate frequency. However this training focuses primarily on natural disasters, fails to address most other crisis types, is mostly reactive and not designed to probe for and uncover key taken-for-granted assumptions. Crisis-probing in health organisations is inadequate, and improvements in this area may well translate into measurable improvements in preparedness and response outcomes.

  7. Health Care Factors Influencing Teen Mothers' Use Of ...

    African Journals Online (AJOL)

    Objective: The study seeks to examine factors associated with teen mothers' use of modern contraceptives after giving birth. Methods: The 2010 Malawi Demographic and Health Survey data was used to test the study objective. A sample of 12, 911 teen mothers aged between 10 and 18 years were extracted from 23, 020 ...

  8. Mother's perceptions of postpartum stress and satisfaction.

    Science.gov (United States)

    Horowitz, J A; Damato, E G

    1999-01-01

    To examine mothers' postpartum perceptions of stress and satisfaction. Methodologic triangulation with quantitative and qualitative data in a nonexperimental design. A convenience sample of 95 women was obtained during normally scheduled postpartum appointments at a health maintenance organization. The self-administered questionnaire included the Mothers' Information Tool (MIT), What Being the Parent of a Baby Is Like (WPL-R), and the Brief Symptom Inventory (BSI). Open-ended MIT items revealed mothers' perceptions of stress and satisfaction. The WPL-R provided maternal satisfaction scores, and the BSI yielded Global Stress Index scores. Content analysis identified the following categories: Roles, Tasks, Resources, and Relationships. Subcategories identified as areas of stress were Work/School, Sleep/Rest, Adjustment/Own Needs, Health/Body Image, Organization of Life, Child Care, Day Care, Housework, Future Challenges, Finances, Housing, Time, Partner, and Family. Subcategories identified as areas of satisfaction were Participating in Relationships, Sharing the Future, Being Proud to Be a Mother, Enjoying a Healthy Baby, and Caring for a Child. Levels of stress and satisfaction of mothers who scored high and low on quantitative measures were compared. The outcomes contribute to the knowledge concerning postpartum women's perceptions of the mothering experience and suggest approaches to nursing assessment and intervention to prevent postpartum adjustment difficulties.

  9. Assessment of health-care waste management in a humanitarian crisis: A case study of the Gaza Strip.

    Science.gov (United States)

    Caniato, Marco; Tudor, Terry Louis; Vaccari, Mentore

    2016-12-01

    Health-care waste management requires technical, financial and human resources, and it is a challenge for low- and middle income countries, while it is often neglected in protracted crisis or emergency situations. Indeed, when health, safety, security or wellbeing of a community is threatened, solid waste management usually receives limited attention. Using the Gaza Strip as the case study region, this manuscript reports on health-care waste management within the context of a humanitarian crisis. The study employed a range of methods including content analyses of policies and legislation, audits of waste arisings, field visits, stakeholder interviews and evaluation of treatment systems. The study estimated a production from clinics and hospitals of 683kg/day of hazardous waste in the Gaza Strip, while the total health-care waste production was 3357 kg/day. A number of challenges was identified including lack of clear definitions and regulations, limited accurate data on which to base decisions and strategies and poor coordination amongst key stakeholders. Hazardous and non-hazardous waste was partially segregated and treatment facilities hardly used, and 75% of the hazardous waste was left untreated. Recommendations for mitigating these challenges posed to patients, staff and the community in general are suggested. The outputs are particularly useful to support decision makers, and re-organize the system according to reliable data and sound assumptions. The methodology can be replicated in other humanitarian settings, also to other waste flows, and other sectors of environmental sanitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. The Effects of Massage by Mothers on Mother-Infant Attachment.

    Science.gov (United States)

    Shoghi, Mahnaz; Sohrabi, Soroor; Rasouli, Mahboobe

    2017-11-04

    Context • Transferring a newborn to the intensive care unit due to a premature birth is a major obstacle in the establishment of emotional attachment between a mother and her child. Researchers believe that the formation and continuation of such an attachment have a profound effect on the child's mental development and behavior in the coming years of life. Not all studies have agreed, however, that skin contact alone, such as massage provides, can improve attachment. Objective • The aim of this study was to determine the effects on maternal attachment behaviors of infants hospitalized in a neonatal intensive care unit (NICU) of massage provided by mothers for their premature neonates. Design • The research team designed a randomized, controlled trial. Setting • The study took place at the Hazrat Ali Asghar Hospital of the Iran University of Medical Sciences (Tehran, Iran). Participants • Participants were 40 mothers and 40 newborns admitted to the NICU at the hospital. Intervention • The study divided participants randomly into a massage (intervention) group and a control group receiving no massages. Mothers in the intervention group trained by watching educational videos and practicing the massage on infant manikins. Subsequently, the intervention group massaged its infants according to a 5-d program, in which each neonate received a 15-min massage session per day. Outcome Measures • Mother-infant attachment behaviors were assessed in both groups 4 times. The maternal attachment scale was used for data collection. Results • According to the statistical analyses, the between-groups difference was not significant at baseline (P > .05). The study showed a statistically significant difference between baseline and postintervention in the mean frequencies of maternal attachment behaviors for both groups (P attachment between the intervention and control groups (P = .000). Conclusion • Massage given to premature neonates by their mothers on a daily

  11. Income and the mental health of Canadian mothers: Evidence from the Universal Child Care Benefit

    Directory of Open Access Journals (Sweden)

    Angela Daley

    2017-12-01

    I find the income transfer improved mental health and life satisfaction regardless of family structure, albeit not necessarily for a given individual. Rather, average scores were higher for mothers with young children after implementation of the Universal Child Care Benefit. For example, they were more likely to report ‘excellent’ mental health and less likely to be in each of the other categories. The transfer also reduced stress among lone mothers with young children. Specifically, they were less likely to be ‘quite a bit’ or ‘extremely’ stressed on a daily basis, and more likely to be ‘not at all’ or ‘not very’ stressed. I argue that assumptions of the model are plausible and show that results are consistent across several robustness checks.

  12. Overcome IMF crisis with idea and invention

    International Nuclear Information System (INIS)

    Wang, Yeon Jung

    1998-01-01

    This book introduces the invention as a tool to overcome IMF crisis. These are the titles of the way to create invention and idea : what is idea? everyone can create something, have a confidence, this is patent, replace or change something, invention is not logical, challenge the normal law, throw away stereotype, movement of idea, original imagination, there are a lot of solutions, there is no expert, have a positive thought, why does inventor invent? necessity is invention of mother, three stage of idea and invention and imitation for invention.

  13. Overcome IMF crisis with idea and invention

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yeon Jung

    1998-01-15

    This book introduces the invention as a tool to overcome IMF crisis. These are the titles of the way to create invention and idea : what is idea? everyone can create something, have a confidence, this is patent, replace or change something, invention is not logical, challenge the normal law, throw away stereotype, movement of idea, original imagination, there are a lot of solutions, there is no expert, have a positive thought, why does inventor invent? necessity is invention of mother, three stage of idea and invention and imitation for invention.

  14. Giving Our Daughters What We Never Received: African American Mothers Discussing Sexual Health With Their Preadolescent Daughters.

    Science.gov (United States)

    Grigsby, Sheila R

    2018-04-01

    African American girls experience disparate rates of pregnancy and acquisition of sexually transmitted infections, including human immunodeficiency virus, when compared to their non-Hispanic White counterparts. Among African American girls, current pregnancy rates are equal to the national crisis levels of teen pregnancy reported in 1990. This qualitative elicitation study was conducted to gain insight into the ways in which African American mothers and their daughters, between the ages of 9 and 14, communicate about sexual health. Early sexual health communication between mothers and daughters is known to enhance the sexual health outcomes of girls. A series of four focus groups and three in-depth interviews were conducted between July and September 2014. The theory of planned behavior was the organizing framework. Theoretical constructs that guided this study were attitudes, perceived behavioral control, and subjective norms. Results showed that what African American women share with their daughters about sexual health stems from their personal faith, values, and experiences. Findings from this study can inform interventions to provide support for this understudied population. Moreover, there are implications for health-care providers, particularly school nurses, who are in an ideal position to help increase mothers' self-efficacy to engage in sexual health conversations with their young daughters.

  15. Impact of Depressive Symptoms on Mother Infant Attachment among Mothers of Preterm Neonates

    Directory of Open Access Journals (Sweden)

    Binu Margaret

    2018-05-01

    Full Text Available Objective: To assess the level of depressive symptoms and mother-infant-attachment among mothers of preterms admitted in Neonatal Intensive Care Unit (NICU and find the relationship between of depressive symptoms and mother-infant-attachment. Materials and methods: A cross sectional survey was conducted among 100 mothers whose preterm babies were admitted in NICU of Kasturba Hospital, Manipal, Karnataka using purposive sampling. Edinburgh Postnatal Depression Scale and Mother Infant Attachment Scale were used to collect the data. Data were analyzed using descriptive and inferential statistics. Results: The mother’s age ranged from 20 to 40 years. The mild depressive symptoms were experienced by 28 (28% mothers, moderate 25(25% and 17 (17% had severe level of depressive symptoms. Majority mothers 77(77% of preterms had good-attachment and 18% had moderate attachment. Mean depressive symptom score and mother-infant-attachment score was 14.36±7.47 and 58.00 ±12.95 respectively. Depressive symptoms and mother-infant-attachment showed moderate negative correlation, (ρ=--0.506, (p=0.001. Conclusion: Increased levels of depressive symptoms among the mothers of preterm neonates affects the mother–infant-interactions. Interventions to decrease the level of depressive symptoms need to be planned for promoting good mother infant interaction.

  16. "It is good to take her early to the doctor" - mothers' understanding of childhood pneumonia symptoms and health care seeking in Kilimanjaro region, Tanzania.

    Science.gov (United States)

    Muro, Florida; Meta, Judith; Renju, Jenny; Mushi, Adiel; Mbakilwa, Hilda; Olomi, Raimos; Reyburn, Hugh; Hildenwall, Helena

    2017-09-22

    Pneumonia is among the leading causes of avoidable deaths for young children globally. The main burden of mortality falls on children from poor and rural families who are less likely to obtain the treatment they need, highlighting inequities in access to effective care and treatment. Caretakers' illness perceptions and care-seeking practices are of major importance for children with pneumonia to receive adequate care. This study qualitatively explores the caretaker concepts of childhood pneumonia in relation to treatment seeking behaviour and health worker management in Moshi urban district, Tanzania. In May - July 2013 data was gathered through different qualitative data collection techniques including five focus group discussions (FGDs) with mothers of children under-five years of age. The FGDs involved free listing of pneumonia symptoms and video presentations of children with respiratory symptoms done, these were triangulated with ten case narratives with mothers of children admitted with pneumonia and eleven in-depth interviews with hospital health workers. Transcripts were coded and analysed using qualitative content analysis. Mothers demonstrated good awareness of common childhood illnesses including pneumonia, which was often associated with symptoms such as cough, flu, chest tightness, fever, and difficulty in breathing. Mothers had mixed views on causative factors and treatments options but generally preferred modern medicine for persisting and severe symptoms. However, all respondent reported access to health facilities as a barrier to care, associated with transport, personal safety and economic constraints. Local illness concepts and traditional treatment options did not constitute barriers to care for pneumonia symptoms. Poor access to health facilities was the main barrier. Decentralisation of care through community health workers may improve access to care but needs to be combined with strengthened referral systems and accessible hospital care for

  17. Clinical profile and outcome of myasthenic crisis in a tertiary care hospital: A prospective study.

    Science.gov (United States)

    Sharma, Sudhir; Lal, Vivek; Prabhakar, Sudesh; Agarwal, Ritesh

    2013-04-01

    The present understanding of the clinical course, complications, and outcome of myasthenic crisis (MC) is based chiefly on observational studies and retrospective case series. To study the baseline demographic and clinical variables, risk factors, complications, outcome, and mortality in patients of MC. All patients of myasthenia gravis (MG) who presented with myasthenic crisis between July 2009 and December 2010 were included. Ten patients of MC were included in this study. The median age of the patients was 40.5 years (range 14-71 years). Seven were females and three were males. Nine had generalized MG and one patient had oculobulbar involvement only. Median duration of disease was 3 years (range 1 month to17 years). Two patients had thymoma. Two patients had history of thymectomy in the past. Infection was the most common triggering factor accounting for five cases (50%) followed by inadequate treatment/drug withdrawal in three (30%) and steroid initiation and hypokalemia in the remaining two patients (20%). Median duration of MC was 12 days (range 3-28 days). Mortality was in 3 out of 10 (30%) during MC. Management in the intensive care unit (ICU) and treatment with plasma exchange/intravenous immunoglobulins were associated with good outcome. Ventilator support and management in intensive care unit are the most important components in the management of MC. The high mortality rate seen in present study may be more reflective of the actual ground reality in resource constrained developing countries, however, larger prospective studies are needed to confirm these findings.

  18. Feminism put to the Test by Nuclear Catastrophe. Mothers, Nature, and Care in Post-Fukushima Japan

    International Nuclear Information System (INIS)

    Gonon, Anne

    2015-01-01

    The nuclear catastrophe in Fukushima raised fundamental questions regarding the care of human beings, but also of the earth itself. Examining the care practices currently being applied in the Fukushima area seems to be a very effective tool for understanding what is being experimented with in terms of the relationships between nature and human beings. However, the usual conceptual frameworks available appear to be of no help. In this article, some possible conceptual attempts are critically explored to suggest that the dominant trends in Japanese feminism, which are divided between maternalism and anti-maternalism, and eco-feminism, which tends to imagine a typically Japanese nature, are not offering the proper analytical tools that might allow us to understand the reality of care in an irradiated environment. The nuclear catastrophe has triggered a crisis in feminist knowledge

  19. The financial crisis in Italy: implications for the healthcare sector.

    Science.gov (United States)

    de Belvis, Antonio Giulio; Ferrè, Francesca; Specchia, Maria Lucia; Valerio, Luca; Fattore, Giovanni; Ricciardi, Walter

    2012-06-01

    The global economic and financial crisis is having and impact on the Italian healthcare system which is undergoing a devolution process from the central government to regions and where about one third of the regional governments (mainly in the central and southern part of the country) are facing large financial deficits. The paper briefly describes the current macro scenario and the main responses taken to face the crisis and highlights the downside risks of introducing "linear" cuts in the allocation of resources. While justified by the risk of a national debt default, present fiscal policies might increase inequalities in access to care, deteriorate overall health indicators and population wellbeing, and sharpen existing difference in the quality of care between regions. Preliminary evidence shows that the crisis is affecting the quality of nutrition and the incidence of psychiatric disorders. During this difficult financial situation Italy is also facing the risk of a major reduction in investments for preventive medicine, Evidence Based Medicine infrastructures, health information systems and physical capital renewal. This cost-cutting strategy may have negative long term consequences Also, important achievement in terms of limiting waiting lists, improving continuity of care and patients' centeredness, and promoting integration between social and health care may be negatively affected by unprecedented resources' cuts. It is essential that in such a period of public funding constraints health authorities monitor incidence of diseases and access to care of the most vulnerable groups and specifically target interventions to those who may be disproportionally hit by the crisis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Attachment behaviors in mothers of premature infants: a descriptive study in Thai mothers.

    Science.gov (United States)

    Tilokskulchai, Fongcum; Phatthanasiriwethin, Sopida; Vichitsukon, Kannikar; Serisathien, Yaowalak

    2002-12-01

    Prematurity and the associated maternal-infant separation after birth can affect the attachment process. The role of nurses in facilitating the process of attachment should be based on an understanding of these behaviors. This descriptive study explored the attachment behaviors demonstrated by mothers during their first visit with their premature infant in the neonatal care unit. The results revealed that all mothers demonstrated most attachment behaviors (ie, inspection, facial expression, touching, verbal expression, and eye-to-eye contact) except holding during their first visit. However, some mothers spent little time with their infant. The findings suggest that nurses should encourage mothers to interact with their infants in order to enhance maternal-infant attachment.

  1. The Relationship between Maternal-Fetal Attachment and Mother-Infant Attachment Behaviors in Primiparous Women Referring to Mashhad Health Care Centers

    Directory of Open Access Journals (Sweden)

    Mahin Taffazoli

    2015-04-01

    Full Text Available Background & aim: Mother-infant bonding and interactions after childbirth are shaped by maternal-fetal attachment during pregnancy. Although many studies have shown the positive correlation between maternal-fetal attachment and mother-infant attachment behaviors, some controversial studies have shown otherwise. Therefore, this study aimed to evaluate the correlation between maternal-fetal attachment and mother-infant attachment behaviors in primiparous women. Methods:This descriptive correlational study was conducted on 100 primiparous women, referring to the selected heath care centers of Mashhad. Data were collected using Cranley's maternal–fetal attachment scale, Avant’s mother-infant attachment tool, Edinburgh postnatal depression scale, and a demographic/obstetric questionnaire including demographic data, obstetric information, delivery outcomes, and postpartum data. Pregnant women with a gestational age of 35-41 weeks, who met the inclusion criteria, completed Cranley's questionnaire, as well as the demographic/obstetric questionnaire. Four and eight weeks after delivery, the subjects were asked to complete the Edinburgh questionnaire and postpartum information; then, they were asked to breastfeed their infants on a chair in a quiet place for 15 minutes. The researcher observed the mothers’ behaviors toward their neonates. For data analysis, descriptive and analytical tests were performed, using SPSS version 16. Results: There was a direct positive relationship between maternal-fetal attachment and mothers’ emotional behaviors toward infants four and eight weeks after delivery. However, four and eight weeks after childbirth, no significant correlation was found between maternal-fetal attachment and mothers’ caring behaviors. Conclusion: According to the findings, maternal-fetal attachment is one of the most important factors for mother-infant attachment. These findings could be applied for enriching mother-infant attachment

  2. Continuity and change in mothers' narratives of perinatal hospice.

    Science.gov (United States)

    Lathrop, Anthony; VandeVusse, Leona

    2011-01-01

    (1) To broadly explore the experiences of women who chose to continue pregnancies affected by lethal fetal diagnoses and (2) to develop knowledge useful to nurses and other healthcare professionals who provide perinatal hospice (PH) care. Qualitative descriptive study using narrative analysis. Fifteen women who learned during their pregnancies of a lethal fetal diagnosis and chose to continue the affected pregnancies. Participants' stories of their PH experiences were recorded in face-to-face interviews. A qualitative approach using narrative analysis was used to identify themes and develop suggestions for care. The element of time was prevalent in mothers' stories. Some aspects of mothers' experiences continued, particularly feelings of love and connection to their babies. Mothers also reported evolving changes in their thoughts and feelings. Personal changes such as increased compassion, faith, and strength were frequently mentioned. Mothers described transient phases of highs and lows. Drawing personal meanings or life lessons was the main way mothers connected their experiences to their present lives. Mothers' descriptions of their experiences can enhance nurses' understanding of perinatal loss. Established care practices, such as birth planning and creating mementoes, were supported. Nurses can help mothers experiencing loss by elucidating and reflecting their personal meanings.

  3. Severe Hypoglycemia Accompanied with Thyroid Crisis

    Directory of Open Access Journals (Sweden)

    Yuki Nakatani

    2012-01-01

    Full Text Available We report a 32-year-old Japanese women with severe hypoglycemia accompanied with thyroid crisis. She complained of dyspnea, general fatigue, and leg edema. She was diagnosed with hyperthyroidism with congestive heart failure and liver dysfunction. Soon after admission, sudden cardiopulmonary arrest occurred. She was then transferred to the intensive care unit. Her serum glucose level was 7 mg/dl. Intravenous glucose, hydrocortisone, diuretics, and continuous hemodiafiltration (CHDF saved her. We considered that hypoglycemia occurred due to heart failure and liver dysfunction due to thyroid crisis.

  4. Effect of the economic crisis on the use of health and home care services among Spanish COPD patients.

    Science.gov (United States)

    de Miguel-Diez, Javier; Lopez-de-Andres, Ana; Herandez-Barrera, Valentin; Jimenez-Trujillo, Isabel; Puente-Maestu, Luis; Cerezo-Lajas, Alicia; Jimenez-Garcia, Rodrigo

    2018-01-01

    Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death worldwide. Consequently, COPD patients are frequent users of health and social resources. Therefore, they are highly vulnerable to decreases in investment in healthcare services. We aimed to describe the utilization of health and home care services among Spanish COPD patients during the economic crisis to identify factors independently associated with changes in the utilization of these services and to study the time trends from 2009 to 2014. We used data from the European Health Interview Surveys for Spain (EHSS) conducted between 2009/2010 (n=22,188) and 2014 (n=22,842). We included responses from adults with COPD aged 40 years or over. Dependent variables included self-reported hospitalizations during the previous year, general practitioner (GP) visits during the last 4 weeks, other health care services used during the previous year (nursing, rehabilitation, and psychological services), and home care services use during the previous year. Independent variables included demographic and socioeconomic characteristics, health status variables, and lifestyles. We identified 1,328 and 1,008 COPD patients from EHSS 2009 and EHSS 2014, respectively. We observed a significant increase in non-GP services use (30.6% in 2009 vs 39.11% in 2014; p home care services use over time. Multivariable models showed that associated factors with a higher use included any chronic comorbidity and worse self-rated health. Physical activity was a strong predictor of fewer hospitalizations and less home care service use. Female sex was associated with significantly fewer hospitalizations (OR 0.72; 95% CI 0.58-0.89). We found an increase in the use of non-GP services (nursing, rehabilitation, and psychological) but not in other health and home care services. The only differences in hospitalizations were observed according to sex. Therefore, the effect of the economic crisis, if any, seems to have been of

  5. Kangaroo Mother Care in Colombia: A Subaltern Health Innovation against For-profit Biomedicine.

    Science.gov (United States)

    Abadía-Barrero, César Ernesto

    2018-01-24

    This ethnographic study presents the origins, growth, and collapse of the first Kangaroo Mother Care (KMC) program, a well-established practice for neonatal care created in 1978 in Colombia. The WHO and UNICEF praised this zero-cost revolutionary technique for its promotion of skin-to-skin contact between premature and low-birth-weight newborns and family members. KMC facilitates early hospital discharge, brings many clinical and psychological benefits, and constitutes an excellent alternative to placing babies in incubators. However, these benefits and political potential against biomedical interventions were undermined after being relabeled as a "reverse innovation," a business concept that encourages corporate investments in low-income countries to develop technologies that can both solve global health problems and boost multinational corporations profits. In response, I propose "subaltern health innovations" as a label for KMC that accounts for the power dynamics in global health between health care initiatives that originate in the Global South and neoliberal configurations of for-profit biomedicine. © 2018 by the American Anthropological Association.

  6. [Effects of Kangaroo Care on anxiety, maternal role confidence, and maternal infant attachment of mothers who delivered preterm infants].

    Science.gov (United States)

    Lee, Sang Bok; Shin, Hye Sook

    2007-10-01

    The purpose of this study was to examine the effects of Kangaroo Care(KC) on anxiety, maternal role confidence, and maternal infant attachment of mothers who delivered preterm infants. The research design was a nonequivalent control group pretest-posttest. Data was collected from September 1. 2006 to June 20. 2007. The participants were 22 mothers in the experimental group and 21 in the control group. KC was applied three times per day, for a total of ten times in 4 days to the experimental group. The degree of anxiety was statistically significantly different between the two groups but maternal role confidence and maternal infant attachment was statistically insignificant. This data suggests that KC was effective for mothers anxiety relief but it was not effective for maternal role confidence and maternal infant attachment of mothers. The implications for nursing practice and directions for future research need to be discussed.

  7. Of mothers and experts: the psychology of post war period and the disciplining of maternal care

    Directory of Open Access Journals (Sweden)

    Claudia Calquín Donoso

    2013-07-01

    Full Text Available The article reflects on the discursive construction of maternal care in psychology. We discuss the emergence of this knowledge and its connections to the political and economic transformations occurred during the postwar period and the beginning of the cold War. From a Foucauldian perspective, the general hypothesis guiding this reflection states that motherly care practices, rather than having an individual and spontaneous character, represent a product of power relationships and knowledge relationships both historically situated and a social practice through which, psychology emerged as science and device of normality and subjectivity.

  8. Wee Care: Reaching Teenage Mothers and Changing Their Lives.

    Science.gov (United States)

    Rosenwald, Priscilla R.; Porter, Gwen

    1989-01-01

    Describes an intervention program for pregnant teenagers and teen mothers. Topics include program development and implementation, staffing, and content. Also discussed are adjustments that a mother must make in order to break the chain of poverty and welfare. (RJC)

  9. Assessment of Day Caring Methods among Civil Servant Mothers of Reproductive Age in Lagos State Nigeria

    Science.gov (United States)

    Akinnubi, Caroline Funmbi

    2016-01-01

    This study examined the day caring methods among the civil servants of reproductive age with children between three months to four years in Lagos State Nigeria. The research design employed for this study was a descriptive research design. A total number of 212 teachers and 128 ministry workers making a total of 340 reproductive age mothers were…

  10. Barriers to health-care and psychological distress among mothers living with HIV in Quebec (Canada).

    Science.gov (United States)

    Blais, Martin; Fernet, Mylène; Proulx-Boucher, Karène; Lebouché, Bertrand; Rodrigue, Carl; Lapointe, Normand; Otis, Joanne; Samson, Johanne

    2015-01-01

    Health-care providers play a major role in providing good quality care and in preventing psychological distress among mothers living with HIV (MLHIV). The objectives of this study are to explore the impact of health-care services and satisfaction with care providers on psychological distress in MLHIV. One hundred MLHIV were recruited from community and clinical settings in the province of Quebec (Canada). Prevalence estimation of clinical psychological distress and univariate and multivariable logistic regression models were performed to predict clinical psychological distress. Forty-five percent of the participants reported clinical psychological distress. In the multivariable regression, the following variables were significantly associated with psychological distress while controlling for sociodemographic variables: resilience, quality of communication with the care providers, resources, and HIV disclosure concerns. The multivariate results support the key role of personal, structural, and medical resources in understanding psychological distress among MLHIV. Interventions that can support the psychological health of MLHIV are discussed.

  11. Interaction during feeding times between mothers and malnourished children under two years of age

    Directory of Open Access Journals (Sweden)

    Paula Chuproski Saldan

    2015-01-01

    Full Text Available This study sought to understand the relations between mothers and malnourished children at feeding times. It is an exploratory study with qualitative data analysis. Data collection was performed at home by means of participant observation with eight mother-child dyads and three grandmothers. Based on the thematic analysis, the following themes emerged: food and interaction; day-to-day care of the child. The families' life situation was unfavorable. Mothers and grandmothers were responsible for preparing family meals, feeding and child care. The mother-child relationships were permeated by gestures of affection, slaps, scolding, and threats during feeding and there were cases of negligence, physical and psychological violence in daily care. Some mothers and grandmothers spoke quietly and cared for the child to be fed and cleaned while others mothers showed little patience for dealing with the child and they became easily irritated. Mothers' life stories were marked by adverse events and most of them faced emotional problems that could have repercussions in relationships with children at feeding times and in daily care. The mother-child interactions at home do not always favor feeding and responsive care, which may further worsen the nutritional status of these children.

  12. Maternity experiences of mothers with multiple disadvantages in England: A qualitative study.

    Science.gov (United States)

    McLeish, Jenny; Redshaw, Maggie

    2018-06-14

    Disadvantaged mothers and their babies are at increased risk of poor perinatal outcomes and have less positive experiences of maternity care. To explore the maternity care experiences of mothers with multiple disadvantages. A qualitative descriptive study based on semi-structured interviews with 40 mothers with multiple disadvantages, using thematic analysis. Four themes emerged: 'A confusing and frightening time', 'Longing to be respected as an individual', 'The importance of choice and control', and 'Needing trust to feel safe'. Mothers brought feelings of powerlessness and low self-esteem to their encounters with maternity professionals, which could be significantly worsened by disrespectful care. They needed support to navigate the complex maternity system. Positive experiences were much more likely where the mother had received continuity of care from a specialist midwife or small team. Mothers with multiple disadvantages value being treated as an individual, making informed choices, and feeling safe, but they may lack the confidence to ask questions or challenge disrespectful treatment. Training and supervision should enable maternity professionals to understand how confusing maternity care can be to very disadvantaged mothers. It should emphasise the need to provide accessible and empowering information and guidance to enable all mothers to make choices and understand the system. Leaders of maternity services need to do more to challenge negative staff attitudes and ensure that that all mothers are treated at all times with kindness, respect and dignity. Specialist midwives can deliver a high quality service to mothers experiencing multiple disadvantages. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. [Public health in major socio-economic crisis].

    Science.gov (United States)

    Cosmacini, G

    2014-01-01

    The term "crisis" in different cultures (such as ancient Greece or China) can have a positive meaning, since it indicates a time of growth, change and opportunity. Over the centuries there have been times of severe economic and social crisis that led to the implementation of major reforms and improved population health. Nowadays, despite the new economic crisis which has also affected health care for its rising costs, health economics does not hesitate to affirm the importance of key objectives such as prevention and medical assistance. Prevention is not prediction. Prevention means "going upstream" and fixing a problem at the source; the goal is to reduce diseases' effects, causes and risk factors, thereby reducing the prevalence of costly medical conditions.

  14. Integration of oral health in primary health care through motivational interviewing for mothers of young children: A pilot study.

    Science.gov (United States)

    Batra, Manu; Shah, Aasim Farooq; Virtanen, Jorma I

    2018-01-01

    Early childhood caries (ECC) continues to affect children worldwide. In India, primary health centers (PHCs) comprises the primary tier where Accredited Social Health Activist (ASHA) provide integrated curative and preventive health care. The aim of the study was to pilot test the integration of oral health in primary health care through motivational interviewing (MI) for mothers of young children provided by ASHAs. The pilot study was conducted in Kashipur, Uttarakhand. From the six PHCs in Kashipur, three were randomly selected, one each was assigned to MI group, traditional health education group, and control group. From 60 mothers with 8-12 months child, ASHAs of all three groups gathered mother's knowledge regarding child's oral health using close-ended questionnaire and diagnosed clinical risk markers of ECC in children and ASHAs of Group A and B imparted the oral health education as per their training. The comparison of ASHA's performances on the MI training competency pre- and post-test showed an overall average of 74% improvement in post-test scores. Interexaminer reliability of the parallel clinical measurements by 6 ASHAs and the investigator for the maxillary central incisors showed 93% of agreement for both dental plaque and dental caries assessment with 0.86 and 0.89 kappa values, respectively. The health education through MI is feasible and can be cost-effective by utilization of ASHAs at PHCs to provide the oral health education to mothers which will in turn improve the oral health status of children.

  15. Myxedema coma: a new look into an old crisis.

    Science.gov (United States)

    Mathew, Vivek; Misgar, Raiz Ahmad; Ghosh, Sujoy; Mukhopadhyay, Pradip; Roychowdhury, Pradip; Pandit, Kaushik; Mukhopadhyay, Satinath; Chowdhury, Subhankar

    2011-01-01

    Myxedema crisis is a severe life threatening form of decompensated hypothyroidism which is associated with a high mortality rate. Infections and discontinuation of thyroid supplements are the major precipitating factors while hypothermia may not play a major role in tropical countries. Low intracellular T3 leads to cardiogenic shock, respiratory depression, hypothermia and coma. Patients are identified on the basis of a low index of suspicion with a careful history and examination focused on features of hypothyroidism and precipitating factors. Arrythmias and coagulation disorders are increasingly being identified in myxedema crisis. Thyroid replacement should be initiated as early as possible with careful attention to hypotension, fluid replacement and steroid replacement in an intensive care facility. Studies have shown that replacement of thyroid hormone through ryles tube with a loading dose and maintenance therapy is as efficacious as intravenous therapy. In many countries T3 is not available and oral therapy with T4 can be used effectively without major significant difference in outcomes. Hypotension, bradycardia at presentation, need for mechanical ventilation, hypothermia unresponsive to treatment, sepsis, intake of sedative drugs, lower GCS and high APACHE II scores and Sequential Organ Failure Assessment (SOFA) scores more than 6 are significant predictors of mortality in myxedema crisis. Early intervention in hypothyroid patients developing sepsis and other precipitating factors and ensuring continued intake of thyroid supplements may prevent mortality and morbidity associated with myxedema crisis.

  16. Myxedema Coma: A New Look into an Old Crisis

    Directory of Open Access Journals (Sweden)

    Vivek Mathew

    2011-01-01

    Full Text Available Myxedema crisis is a severe life threatening form of decompensated hypothyroidism which is associated with a high mortality rate. Infections and discontinuation of thyroid supplements are the major precipitating factors while hypothermia may not play a major role in tropical countries. Low intracellular T3 leads to cardiogenic shock, respiratory depression, hypothermia and coma. Patients are identified on the basis of a low index of suspicion with a careful history and examination focused on features of hypothyroidism and precipitating factors. Arrythmias and coagulation disorders are increasingly being identified in myxedema crisis. Thyroid replacement should be initiated as early as possible with careful attention to hypotension, fluid replacement and steroid replacement in an intensive care facility. Studies have shown that replacement of thyroid hormone through ryles tube with a loading dose and maintenance therapy is as efficacious as intravenous therapy. In many countries T3 is not available and oral therapy with T4 can be used effectively without major significant difference in outcomes. Hypotension, bradycardia at presentation, need for mechanical ventilation, hypothermia unresponsive to treatment, sepsis, intake of sedative drugs, lower GCS and high APACHE II scores and Sequential Organ Failure Assessment (SOFA scores more than 6 are significant predictors of mortality in myxedema crisis. Early intervention in hypothyroid patients developing sepsis and other precipitating factors and ensuring continued intake of thyroid supplements may prevent mortality and morbidity associated with myxedema crisis.

  17. Downsizing, Competition, and Organizational Change in Government: Is Necessity the Mother of Invention?

    Science.gov (United States)

    Kelman, Steven

    2006-01-01

    One answer to the question of why government organizations don't perform better - common in academic "public choice" literature but also in folk wisdom--is that resources come too easily, independent of performance. Some business management literature suggests that a crisis in resource flows can force successful change--"necessity is the mother of…

  18. Traditional Baby Care Practices of Mothers of Children Aged 6-12 Months in The Provincial Centre of Trabzon, Turkey

    Directory of Open Access Journals (Sweden)

    Ilknur Kahriman

    2011-02-01

    Full Text Available Aim: To evaluate traditional baby care practices employed by mothers in the Turkish province of Trabzon. Materials and methods: This descriptive study was planned around babies born in the provincial center of Trabzon between 1 June and 31 December, 2005, and aged 6-12 months at the time of the research. Data were collected in July-September 2006. In order to determine sampling size the prevalence of mothers using traditional practices was calculated at 50%, with a deviation of 0.05, giving a sample size of 384 mothers, the final number being put at 400. The study was performed at six clinics selected on the basis of settlement location and socioeconomic level out of 11 health clinics in the city center of the province of Trabzon. Data in the study are presented as numbers, and percentage distributions as mean±standard deviation. Results: It was determined that 69.8% of mothers breastfed their babies immediately and that 91.3% gave them colostrum. It was also determined that 3.7% of mothers resorted to various practices in order to ensure a male or female baby, 44.5% in order to facilitate labor, 25% in order to avoid puerperal fever, 63.5% in order eliminate postnatal pain, 88% to prevent their babies smelling, 86.2% for the shedding of the umbilical cord, 54.2% to protect their babies against jaundice, 73.7% to protect their babies from the evil eye, 26.2% so their babies would be good-looking and 40.7% to safely complete the first 40 days after childbirth. The main practices having a harmful effect on health in the study were swaddling, salting the baby, waiting for the call to prayer before breastfeeding the baby after birth and not giving colostrum. Conclusions: Traditions were observed to have an impact and to be persisting in child care in Trabzon. This suggests it will be useful for health personnel working in the field of infant care to evaluate the traditional characteristics in the locations where they work and to correct negative

  19. How Can Schools Address America's Marriage Crisis? Prepare Young People for Rewarding Careers

    Science.gov (United States)

    Petrilli, Michael P.

    2015-01-01

    There are no obvious or easy prescriptions for reversing the trends of the familial challenges that have grown deeper and wider in the last fifty years in regard to the number of babies born to unwed mothers, with the majority of all children born to women in their 20s. This article discusses the challenges regarding the marriage crisis in…

  20. Work/non-workday differences in mother, child, and mother-child morning cortisol in a sample of working mothers and their children.

    Science.gov (United States)

    Hibel, Leah C; Trumbell, Jill M; Mercado, Evelyn

    2014-01-01

    Mothers have been shown to have higher morning cortisol on days they go to work compared to non-workdays; however, it is unknown how maternal workday associates with child morning cortisol or the attunement of mother-child morning cortisol. This study examined the presence and stability of morning cortisol levels and slopes (i.e., cortisol awakening response or CAR) in a sample of 2-4year old children in out-of-home child care with working mothers. In addition, we examined the differential contributions of maternal workday on mother-child attunement in morning cortisol. Mother and child morning cortisol was sampled twice a day (awakening and 30min later) across four consecutive days (2 non-workdays; 2 workdays) among 47 working mothers and their young children. Mothers also reported on compliance with sampling procedures and provided demographic information. While children exhibited stability in cortisol levels, children's CARs were variable, with children's non-work CARs not predictive of work CARs. Similarly, a significant morning rise in cortisol was only found on workdays, not non-workdays. Overall, mothers had higher cortisol levels and steeper CARs than their children. Further, maternal workday moderated the attunement of mother-child morning cortisol, such that mothers and children had concordant cortisol levels on non-workdays, but discordant cortisol levels on workdays. Morning cortisol may be more variable in pre-school aged children than adults but may be similarly responsive to the social environment. Further, workday mornings may be a time of reduced mother-child cortisol attunement. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Impact of mothers’ employment on infant feeding and care: a qualitative study of the experiences of mothers employed through the Mahatma Gandhi National Rural Employment Guarantee Act

    Science.gov (United States)

    Nair, Manisha; Ariana, Proochista; Webster, Premila

    2014-01-01

    Objective To explore the experiences of mothers employed through the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) using focus group discussions (FGDs) to understand the impact of mothers’ employment on infant feeding and care. The effects of mothers’ employment on nutritional status of children could be variable. It could lead to increased household income, but could also compromise child care and feeding. Setting The study was undertaken in the Dungarpur district of Rajasthan, India. Participants Mothers of infants employment compromises infant feeding and care’, ‘caregivers’ inability to substitute mothers’ care’, ‘compromises related to childcare and feeding outweigh benefits from MGNREGA’ and ‘employment as disempowering’. Mothers felt that the comprises to infant care and feeding due to long hours of work, lack of alternative adequate care arrangements, low wages and delayed payments outweighed the benefits from the scheme. Conclusions This study provides an account of the trade-off between mothers’ employment and child care. It provides an understanding of the household power relationships, societal and cultural factors that modulate the effects of mothers’ employment. From the perspective of mothers, it helps to understand the benefits and problems related to providing employment to women with infants in the MGNREGA scheme and make a case to pursue policy changes to improve their working conditions. PMID:24694624

  2. Life as a Mother-Scientist

    Science.gov (United States)

    Louis, Lucille

    2006-01-01

    In this article, the author shares the difficulties she faced as she tried to reach a balance between her career as a scientist and her role as a mother. She speaks of how she often found problems in putting her children into day care centers. She also relates that the confidence mothers have in their academic careers is correlated to the quality…

  3. Risk factors for the development of post-traumatic stress disorder and coping strategies in mothers and fathers following infant hospitalisation in the neonatal intensive care unit.

    Science.gov (United States)

    Aftyka, Anna; Rybojad, Beata; Rosa, Wojciech; Wróbel, Aleksandra; Karakuła-Juchnowicz, Hanna

    2017-12-01

    The aim of this study was to identify the potential risk factors for the development of post-traumatic stress disorder in mothers and fathers following infant hospitalisation in the neonatal intensive care unit. The development of neonatal intensive care units has increased the survival rate of infants. However, one of the major parental problems is post-traumatic stress disorder. An observational study covered 125 parents (72 mothers and 53 fathers) of infants aged 3-12 months who were hospitalised in the neonatal intensive care unit during the neonatal period. Third-referral neonatal intensive care unit. Several standardised and self-reported research tools were used to estimate the level of post-traumatic stress symptoms (Impact Event Scale-Revised), perceived stress (Perceived Stress Scale) and coping strategies (COPE Inventory). The respondents also completed a Parent and Infant Characteristic Questionnaire. The mothers and fathers did not differ in their parental and infant characteristics. Post-traumatic stress disorder was present in 60% of the mothers and 47% of the fathers. Compared to the fathers, the mothers felt greater stress (p = .020) and presented a higher severity of post-traumatic stress disorder (p stress disorder in the mothers. In the fathers, an Apgar test at 1 min after birth (p = .030) and a partner's post-traumatic stress disorder (p = .038) were related to post-traumatic stress disorder. The mothers compared to the fathers were more likely to use strategies such as: positive reinterpretation and growth, focusing on and venting of emotions, instrumental social support, religious coping and acceptance. In the fathers, the predictors included an Apgar score at 1 min after birth, a lack of congenital anomalies in the child and mental disengagement. Risk factors for post-traumatic stress disorder, as well as coping strategies, differ in women compare to men. Knowledge of risk factors for post-traumatic stress disorder, specific to

  4. Working with complexity: experiences of caring for mothers seeking residential parenting services in New South Wales, Australia.

    Science.gov (United States)

    Fowler, Cathrine; Schmied, Virginia; Dickinson, Marie; Dahlen, Hannah Grace

    2017-02-01

    To investigate staff perception of the changing complexity of mothers and infants admitted to two residential parenting services in New South Wales in the decade from 2005-2015. For many mothers with a young child, parenting is difficult and stressful. If parenting occurs within the context of anxiety, mental illness or abuse it often becomes a high-risk situation for the primary caregiver. Residential parenting services provide early nursing intervention before parenting problems escalate and require physical or mental health focused care. A qualitative descriptive design using semi-structured interview questions was used as phase three of a larger study. Data were gathered from 35 child and family health nurses and ten physicians during eight focus groups. Three main themes emerged: (1) dealing with complexity; (2) changing practice; and (3) appropriate knowledge and skills to handle greater complexity. There was a mix of participant opinions about the increasing complexity of the mothers presenting at residential parenting services during the past decade. Some of the nurses and physicians confirmed an increase in complexity of the mothers while several participants proposed that it was linked to their increased psychosocial assessment knowledge and skill. All participants recognised their work had grown in complexity regardless of their perception about the increased complexity of the mothers. Australian residential parenting services have a significant role in supporting mothers and their families who are experiencing parenting difficulties. It frequently provides early intervention that helps minimise later emotional and physical problems. Nurses are well placed to work with and support mothers with complex histories. Acknowledgement is required that this work is stressful and nurses need to be adequately supported and educated to manage the complex presentations of many families. © 2016 John Wiley & Sons Ltd.

  5. Presentation of the CEA's crisis national organization: coordination centre in case of crisis, crisis technical teams, intervention means, and so on; Presentation de l'organisation nationale de crise du CEA: centre de coordination en cas de crise, equipes techniques de crise, moyens d'intervention...

    Energy Technology Data Exchange (ETDEWEB)

    Pectorin, X. [CEA Fontenay-aux-Roses, MR/DCS/DIR, 92 (France)

    2010-07-01

    After having briefly recalled the existence of a legal framework for crisis management organisation, this report briefly describes how the CEA plans the crisis management. This management is based on the definition of critical scenarios, on the building up of a crisis management team, and on the elaboration of crisis management operational documents. It evokes the alert organisation and the triggering of crisis management. Then, it describes the CEA's national crisis organisation with its main crisis management structures, the role and the operation of the Crisis Coordination Centre (CCC, the decision body), the role and operation of the Central Crisis Technical Teams (ETC-C, Equipes Techniques de Crise Centrales), the role of field interveners (various rescue, protection, health care and technical teams) and of other additional intervention actors. It evokes the objectives of the various exercises which are organised every year at the internal, national or international level

  6. Maternal DRD2, SLC6A3, and OXTR genotypes as potential moderators of the relation between maternal history of care and maternal cortisol secretion in the context of mother-infant separation.

    Science.gov (United States)

    Ludmer, Jaclyn A; Jamieson, Brittany; Gonzalez, Andrea; Levitan, Robert; Kennedy, James; Villani, Vanessa; Masellis, Mario; Basile, Vincenzo S; Atkinson, Leslie

    2017-10-01

    A mother's cortisol secretion is importantly associated with her own mental health and her infant's cortisol secretion. This study investigated the influences of maternal history of care and maternal DRD2, SLC6A3, and OXTR genotypes on maternal cortisol in the context of infant stress. A community sample of 296 mother-infant dyads completed a maternal separation at infant age 17 months. Maternal salivary cortisol, buccal cells, and self-reported history of care were collected. Multilevel models revealed that history of care had a greater influence on maternal baseline cortisol (but not cortisol trajectory) for mothers with more plasticity alleles of SLC6A3 (10R) and OXTR (G), relative to mothers with fewer or no plasticity alleles. Findings indicate that a mother's history of care is related to her cortisol secretion in anticipation of infant stress, but that this relation depends on her genetic characteristics. Findings are discussed in relation to the maternal protective system and anticipatory cortisol secretion. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Learning Crisis Unit through Post-Crisis: Characteristics and Mechanisms

    Science.gov (United States)

    Chebbi, Hela; Pündrich, Aline Pereira

    2015-01-01

    Purpose: This paper aims to identify the characteristics that a crisis unit should have to achieve effective learning after crisis. Literature has identified many relations between learning organizations and crisis; yet, there is a dearth of research on specific studies about crisis units and their post-crisis learning features. Thus, this paper…

  8. Has the quality of health care for the immigrant population changed during the economic crisis in Catalonia (Spain)? Opinions of health professionals and immigrant users.

    Science.gov (United States)

    Porthé, Victoria; Vargas, Ingrid; Ronda, Elena; Malmusi, Davide; Bosch, Lola; Vázquez, M Luisa

    2017-06-02

    To analyse changes in health professionals' and immigrant users' perceptions of the quality of care provided to the immigrant population during the crisis. A qualitative descriptive-interpretative and exploratory study was conducted in two areas of Catalonia. Semi-structured individual interviews were used with a theoretical sample of medical (n=24) and administrative (n=10) professionals in primary care (PC) and secondary care (SC), and immigrant users (n=20). Thematic analysis was conducted and the results were triangulated. Problems related to technical and interpersonal quality emerged from the discourse of both professionals and immigrants. These problems were attributed to cutbacks during the economic crisis. Regarding technical quality, respondents reported an increase in erroneous or non-specific diagnoses, inappropriate use of diagnostic tests and non-specific treatments, due to reduction in consultation times as a result of cuts in human resources. With regard to interpersonal quality, professionals reported less empathy, and users also reported worse communication, due to changes in professionals' working conditions and users' attitudes. Finally, a reduction in the resolution capacity of the health services emerged: professionals described unnecessary repeated PC visits and limited responses in SC, while young immigrants reported an insufficient response to their health problems. The results indicate a deterioration in perceived technical and interpersonal quality during the economic crisis, due to cutbacks mainly in human resources. These changes affect the whole population, but especially immigrants. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Crisis and Crisis Scenarios

    DEFF Research Database (Denmark)

    Larsen, Øjvind

    2016-01-01

    This special issue of Nordicum-Mediterraneum contains select proceedings from the third meeting of the Nordic Summer University research circle called “Crisis and Crisis Scenarios: Normativity, Possibilities and Dilemmas”, held April 9th — 12th, 2015 at the Lysebu Conference Centre in Oslo, Norway....... The circle’s research program runs from 2014 to 2016 and is aimed at examining the concept of crisis as it is used today in academia and public discussion. In this collection of papers from the symposium we present some of the different ways in which the topic of the study group was addressed....

  10. The correlation between stress and economic crisis: a systematic review

    Directory of Open Access Journals (Sweden)

    Mucci N

    2016-04-01

    Full Text Available Nicola Mucci,1 Gabriele Giorgi,2 Mattia Roncaioli,3 Javier Fiz Perez,2 Giulio Arcangeli11Department of Experimental and Clinical Medicine, University of Florence, Florence, 2Department of Psychology, European University of Rome, Rome, 3Department of Biomedical Sciences for Health, University of Milan, Milan, ItalyAbstract: In 2008 a deep economic crisis started in the US and rapidly spread around the world. The crisis severely affected the labor market and employees’ well-being. Hence, the aim of this work is to implement a systematic review of the principal studies that analyze the impact of the economic crisis on the health of workers. We conducted our search on the PubMed database, and a total of 19 articles were selected for review. All studies showed that the economic crisis was an important stressor that had a negative impact on workers’ mental health. Most of the studies documented that a rise in unemployment, increased workload, staff reduction, and wages reduction were linked to an increased rate of mood disorders, anxiety, depression, dysthymia, and suicide. Some studies showed that problems related to the crisis may have also affected the general health of workers by increasing the risk of such health problems as cardiovascular and respiratory diseases. Finally, some studies looked at the impact of the crisis on health care services. These studies demonstrated that the reduction in public expenditure on health care services, and the reduction of public hospital budgets due to the recession, led to organizational problems (eg, medical supply shortages.Keywords: economic crisis, recession, work-related stress, mental health, risks assessment, occupational medicine

  11. [Development of an Instrument to Assess the Quality of Childbirth Care from the Mother's Perspective].

    Science.gov (United States)

    Jeong, Geum Hee; Kim, Hyun Kyoung; Kim, Young Hee; Kim, Sun Hee; Lee, Sun Hee; Kim, Kyung Won

    2018-02-01

    This study aimed to develop an instrument to assess the quality of childbirth care from the perspective of a mother after delivery. The instrument was developed from a literature review, interviews, and item validation. Thirty-eight items were compiled for the instrument. The data for validity and reliability testing were collected using a questionnaire survey conducted on 270 women who had undergone normal vaginal delivery in Korea and analyzed with descriptive statistics, exploratory factor analysis, and reliability coefficients. The exploratory factor analysis reduced the number of items in the instrument to 28 items that were factored into four subscales: family-centered care, personal care, emotional empowerment, and information provision. With respect to convergence validation, there was positive correlation between this instrument and birth satisfaction scale (r=.34, pinstrument could be used as a measure of the quality of nursing care for women who have a normal vaginal delivery. © 2018 Korean Society of Nursing Science.

  12. Depressive symptoms among immigrant and Canadian born mothers of preterm infants at neonatal intensive care discharge: a cross sectional study

    Science.gov (United States)

    2013-01-01

    Background Mothers of preterm infants are considered at higher risk for depressive symptoms, higher than for mothers of healthy term infants. Predictors of depressive symptoms in mothers of preterm infants are not yet well established. Immigrant mothers of term infants have higher prevalence of depressive symptoms than Canadian born mothers but the relative prevalence for immigrant mothers of preterm infants is unknown. This study had two aims: (i) to investigate the prevalence of depressive symptoms in immigrant as compared to Canadian born mothers of preterm infants, and (ii) to determine what factors are associated with depressive symptoms in mothers of preterm infants. Methods This is a multi-site, cross sectional study of mothers whose preterm infants required hospitalization in neonatal intensive care unit (NICU). Consecutive eligible mothers (N = 291) were recruited during the week prior to their infant’s NICU discharge. Mothers completed a self-administered questionnaire booklet of validated psychosocial/cultural measures including the Center for Epidemiological Studies Depression Scale (CES-D), Parental Stressor Scale:NICU, General Functioning Subscale of the McMaster Family Assessment Device, Social Support Index, and Vancouver Index of Acculturation; and demographic characteristics questions. Infant characteristics included gestational age, birth weight, sex, singleton/multiple birth, and Score for Neonatal Acute Physiology-II. Results Immigrant mothers (N = 107), when compared to Canadian born mothers (N = 184), reported more depressive symptoms, poorer family functioning, less social support, and less mainstream acculturation. Hierarchical regression for a subsample of 271 mothers indicated that single parent status, high stress, poorer family functioning, and less social support were associated with increased depressive symptoms and accounted for 39% of the variance on the CES-D. Immigrant status did not contribute significantly to the final

  13. Depressive symptoms among immigrant and Canadian born mothers of preterm infants at neonatal intensive care discharge: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Ballantyne Marilyn

    2013-01-01

    Full Text Available Abstract Background Mothers of preterm infants are considered at higher risk for depressive symptoms, higher than for mothers of healthy term infants. Predictors of depressive symptoms in mothers of preterm infants are not yet well established. Immigrant mothers of term infants have higher prevalence of depressive symptoms than Canadian born mothers but the relative prevalence for immigrant mothers of preterm infants is unknown. This study had two aims: (i to investigate the prevalence of depressive symptoms in immigrant as compared to Canadian born mothers of preterm infants, and (ii to determine what factors are associated with depressive symptoms in mothers of preterm infants. Methods This is a multi-site, cross sectional study of mothers whose preterm infants required hospitalization in neonatal intensive care unit (NICU. Consecutive eligible mothers (N = 291 were recruited during the week prior to their infant’s NICU discharge. Mothers completed a self-administered questionnaire booklet of validated psychosocial/cultural measures including the Center for Epidemiological Studies Depression Scale (CES-D, Parental Stressor Scale:NICU, General Functioning Subscale of the McMaster Family Assessment Device, Social Support Index, and Vancouver Index of Acculturation; and demographic characteristics questions. Infant characteristics included gestational age, birth weight, sex, singleton/multiple birth, and Score for Neonatal Acute Physiology-II. Results Immigrant mothers (N = 107, when compared to Canadian born mothers (N = 184, reported more depressive symptoms, poorer family functioning, less social support, and less mainstream acculturation. Hierarchical regression for a subsample of 271 mothers indicated that single parent status, high stress, poorer family functioning, and less social support were associated with increased depressive symptoms and accounted for 39% of the variance on the CES-D. Immigrant status did not contribute

  14. Pediatric symptom checklist ratings by mothers with a recent history of intimate partner violence: a primary care study.

    Science.gov (United States)

    Klassen, Brian J; Porcerelli, John H; Sklar, Elyse R; Markova, Tsveti

    2013-12-01

    Screening for psychosocial problems is an effective way to identify children who need further evaluation, and many brief, psychometrically strong measures exist for this purpose. More research is needed, however, about the performance of these measures in special populations who are familiar to primary care settings. The purpose of this study was to examine and compare maternal ratings on the Pediatric Symptom Checklist (PSC) between low-income, urban mothers who had suffered intimate partner violence (IPV) in the past year (n = 23) and a demographically-matched comparison group of mothers (n = 23). Victims of violence rated their children as having significantly more problems in a number of categories (Total PSC Score, Externalizing, and Internalizing) than did mothers in the comparison group. The PSC shows promise as an adequate screening tool for psychosocial problems in the children of women who have suffered IPV, but more research is needed.

  15. The other side of caring: adult children with mental illness as supports to their mothers in later life.

    Science.gov (United States)

    Greenberg, J S

    1995-05-01

    This article discusses the role of adult children with serious mental illness as a source of support to their aging parents. The data come from a cross-sectional study of 105 mothers age 55 and older who were living with and caring for an adult child with a serious mental illness. The mothers participated in in-depth face-to-face interviews conducted in their homes and also completed a set of self-administered questionnaires. The majority of mothers in this study reported that their children provided at least some ongoing help with a range of daily living tasks. As hypothesized, the adult child's assistance and support were related significantly to lower levels of maternal subjective burden. By beginning to acknowledge the contributions that people with mental illness make to their families, social workers can help clients maintain and sustain self-esteem and improve the quality of their lives.

  16. Crisis Communication Online

    DEFF Research Database (Denmark)

    Utz, Sonja; Schultz, Friederike; Glocka, Sandra

    2013-01-01

    Social media play in today's societies a fundamental role for the negotiation and dynamics of crises. However, classical crisis communication theories neglect the role of the medium and focus mainly on the interplay between crisis type and crisis communication strategy. Building on the recently...... developed “networked crisis communication model” we contrast effects of medium (Facebook vs. Twitter vs. online newspaper) and crisis type (intentional vs. victim) in an online experiment. Using the Fukushima Daiichi nuclear disaster as crisis scenario, we show that medium effects are stronger than...... the effects of crisis type. Crisis communication via social media resulted in a higher reputation and less secondary crisis reactions such as boycotting the company than crisis communication in the newspaper. However, secondary crisis communication, e.g. talking about the crisis communication, was higher...

  17. [Adult mother-daughter relationships and psychological well-being: attachment to mothers, depressive symptoms, and self-esteem].

    Science.gov (United States)

    Kitamura, Kotomi

    2008-06-01

    This study examined how daughter's reported quality of their mother-daughter relationships during childhood and adulthood is related to their psychological well-being (depressive symptoms and self-esteem). A cross-sectional sample of 363 women, age 26 to 35 years, completed questionnaires. The association between the quality of daughters' relationships with their mothers and their psychological well-being depended on the daughters' marital and parental status. Regression estimates suggested that among single daughters and married daughters with children, childhood attachment dimensions (avoidance and anxiety) significantly contributed to psychological well-being, even after controlling for the effects of current closeness and excessive dependence. Current closeness, and excessive care seeking and care giving to their mother contributed to the psychological well-being of single daughters and married daughters without children, even after controlling for the effects of childhood attachment.

  18. Perceived Stress in Breastfeeding Working Mothers in Iran

    Directory of Open Access Journals (Sweden)

    Sousan Valizadeh

    2016-11-01

    Full Text Available Working breastfeeding mothers because of multiple and conflicting roles and demands in home and work-place experience high level of stress. Identifying perceived stress of this group of mothers can be helpful in their life promotion. This study aimed to describe the experiences of sixteen Iranian breastfeeding mothers who returned to work and to discover, through in depth, semi-structured interviews their perceived stress. All interviews were recorded, transcribed and analyzed using thematic-analysis. Two main themes emerged by analyzing data about perceived stress: 1 "Not being a good mother" with subthemes of aFeeling of cruelty toward the child and b Child neglect of maternal care; and 2 "Feeling trapped" with subthemes of a Inflexible expectations and 2 Forgotten identity. Findings of this study emphasize the need to promote awareness of spouses of this group of mothers about the difficult situation which mothers face with and planning to promote their participation especially in care of child. Providing family-friendly policies in work-place is suggested.

  19. Mothers' psychological adaptation to Duchenne/Becker muscular dystrophy

    Science.gov (United States)

    Peay, Holly L; Meiser, Bettina; Kinnett, Kathleen; Furlong, Pat; Porter, Kathryn; Tibben, Aad

    2016-01-01

    Duchenne and Becker muscular dystrophy (DBMD) cause significant emotional and care-related burden on caregivers, but no studies have evaluated predictors of positive caregiver outcomes, including disorder-specific psychological adaptation. Using a community-engaged approach focused on supporting mothers in positive aspects of caregiving, this prospective study aims to assess (i) the association between child's baseline functional status and mothers' illness perceptions, resilience, and coping self-efficacy; and (ii) predictors of mothers' psychological adaptation to caring for a child with DBMD. Biological mothers with at least one living child with DBMD completed a baseline survey (n=205) with 1-year (n=147) and 2-year (n=144) follow-up surveys. Worse child's baseline function was associated not only with increased caregiver burden and reduced maternal resilience, but also with perception of positive disease impact on the family. At two follow-ups, increased psychological adaptation to DBMD was predicted by resilience (β=0.264, P=0.001) and perceived positive impact (β=0.310, P<0.001), controlling for mother's age (β=−0.305, P<0.001) and income (β=−0.088, P=0.245). Child's functional status and caregiver burden of DBMD did not predict DBMD-specific adaptation. Though clinicians caring for families with DBMD should anticipate increased caregiver burden as the disorder progresses, interventions focused on caregiver burden are not expected to influence mothers' psychosocial adaptation. Efforts to improve mothers' well-being should focus on fostering mothers' resilience and enhancing perceptions of positive disease impact (benefit finding). Results suggest that psychosocial interventions can highlight strengths and well-being rather than burden and deficit. PMID:26306645

  20. Integration of oral health in primary health care through motivational interviewing for mothers of young children: A pilot study

    Directory of Open Access Journals (Sweden)

    Manu Batra

    2018-01-01

    Full Text Available Introduction: Early childhood caries (ECC continues to affect children worldwide. In India, primary health centers (PHCs comprises the primary tier where Accredited Social Health Activist (ASHA provide integrated curative and preventive health care. The aim of the study was to pilot test the integration of oral health in primary health care through motivational interviewing (MI for mothers of young children provided by ASHAs. Subjects and Methods: The pilot study was conducted in Kashipur, Uttarakhand. From the six PHCs in Kashipur, three were randomly selected, one each was assigned to MI group, traditional health education group, and control group. From 60 mothers with 8–12 months child, ASHAs of all three groups gathered mother's knowledge regarding child's oral health using close-ended questionnaire and diagnosed clinical risk markers of ECC in children and ASHAs of Group A and B imparted the oral health education as per their training. Results: The comparison of ASHA's performances on the MI training competency pre- and post-test showed an overall average of 74% improvement in post–test scores. Interexaminer reliability of the parallel clinical measurements by 6 ASHAs and the investigator for the maxillary central incisors showed 93% of agreement for both dental plaque and dental caries assessment with 0.86 and 0.89 kappa values, respectively. Conclusion: The health education through MI is feasible and can be cost-effective by utilization of ASHAs at PHCs to provide the oral health education to mothers which will in turn improve the oral health status of children.

  1. Scaling up kangaroo mother care in South Africa: 'on-site' versus 'off-site' educational facilitation

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    van Rooyen Elise

    2008-07-01

    Full Text Available Abstract Background Scaling up the implementation of new health care interventions can be challenging and demand intensive training or retraining of health workers. This paper reports on the results of testing the effectiveness of two different kinds of face-to-face facilitation used in conjunction with a well-designed educational package in the scaling up of kangaroo mother care. Methods Thirty-six hospitals in the Provinces of Gauteng and Mpumalanga in South Africa were targeted to implement kangaroo mother care and participated in the trial. The hospitals were paired with respect to their geographical location and annual number of births. One hospital in each pair was randomly allocated to receive either 'on-site' facilitation (Group A or 'off-site' facilitation (Group B. Hospitals in Group A received two on-site visits, whereas delegates from hospitals in Group B attended one off-site, 'hands-on' workshop at a training hospital. All hospitals were evaluated during a site visit six to eight months after attending an introductory workshop and were scored by means of an existing progress-monitoring tool with a scoring scale of 0–30. Successful implementation was regarded as demonstrating evidence of practice (score >10 during the site visit. Results There was no significant difference between the scores of Groups A and B (p = 0.633. Fifteen hospitals in Group A and 16 in Group B demonstrated evidence of practice. The median score for Group A was 16.52 (range 00.00–23.79 and that for Group B 14.76 (range 07.50–23.29. Conclusion A previous trial illustrated that the implementation of a new health care intervention could be scaled up by using a carefully designed educational package, combined with face-to-face facilitation by respected resource persons. This study demonstrated that the site of facilitation, either on site or at a centre of excellence, did not influence the ability of a hospital to implement KMC. The choice of outreach

  2. L’Italia: una crisi nella crisi

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    Alessandro Roncaglia

    2011-01-01

    Full Text Available The article synthesises the large and extending literature on the financial and economic crisis from a Post-Keynesian point of view. The authors take on the position that the international and internal real imbalances are serious and worrying, but yet they are not the cause of the crisis or of its tremendous dimension. The flawed and insufficient regulation of finance is the prime cause of the crisis, as well as it is one of the main hindrances to expansionary macroeconomic policies that may less painfully drive developed countries out of the crisis. It then examines the most recent developments in the euro-area, claiming that we are not facing a sovereign debt crisis but rather a speculative attack on the euro. Finally, the article considers specifically the situation of Italy, currently at the hearth of such an attack, and suggests that the country was already facing critical developments before the 2007/2008 crisis. Thus, the policy measures so far suggested to exit the current stressful situation, in so far as they ignore this fact, seriously run the risk of proving insufficient or altogether noxious.

  3. Attitudes toward teen mothers among nursing students and psychometric evaluation of Positivity Toward Teen Mothers scale.

    Science.gov (United States)

    Kim, Son Chae; Burke, Leanne; Sloan, Chris; Barnett, Shannon

    2013-09-01

    To prepare future nurses who can deliver high quality nursing care to teen mothers, a better understanding of the nursing students' perception of teen mothers is needed. A descriptive cross-sectional study was conducted among 228 nursing students to evaluate the psychometric properties of the Positivity Toward Teen Mothers (PTTM) scale, to explore nursing students' general empathy and attitudes toward teen mothers, and to investigate the predictors of nursing students' attitudes toward teen mothers. Principal component factor analysis with varimax rotation resulted in a 19-item PTTM-Revised scale with Non-judgmental and Supportive subscales. Cronbach's alphas for the subscales were 0.84 and 0.69, respectively, and 0.87 for the total scale. Simultaneous multiple regression models showed that general empathy and having a teen mother in the family or as an acquaintance were significant predictors of positive attitudes toward teen mothers, whereas age was a significant negative predictor. The PTTM-Revised scale is a promising instrument for assessing attitudes toward teen mothers. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. The Economic Crisis and Public Health

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    Victor Sidel

    2009-06-01

    Full Text Available The current global economic crisis seriously threatens the health of the public. Challenges include increases in malnutrition; homelessness and inadequate housing; unemployment; substance abuse, depression, and other mental health problems; mortality; child health problems; violence; environmental and occupational health problems; and social injustice and violation of human rights; as well as decreased availability, accessibility, and affordability of quality medical and dental care. Health professionals can respond by promoting surveillance and documentation of human needs, reassessing public health priorities, educating the public and policymakers about health problems worsened by the economic crisis, advocating for sound policies and programs to address these problems, and directly providing necessary programs and services.

  5. Clever mothers balance time and effort in parental care: a study on free-ranging dogs

    OpenAIRE

    Paul, Manabi; Sau, Shubhra; Nandi, Anjan K.; Bhadra, Anindita

    2016-01-01

    Mammalian offspring require parental care, at least in the form of suckling during their early development. While mothers need to invest considerable time and energy in ensuring the survival of their current offspring, they also need to optimize their investment in one batch of offspring in order to ensure future reproduction and hence lifetime reproductive success. Free-ranging dogs live in small social groups, mate promiscuously, and lack the cooperative breeding biology of other group livi...

  6. Something in the Water: Hospital Responds to Water Crisis.

    Science.gov (United States)

    Redfern, Roberta; Micham, Jennifer; Daniels, Rebecca; Childers, Sue

    2018-02-05

    Early on August 2, 2014, in the city of Toledo, Ohio, a media alert informed the public that traces of microcystin, a hazardous toxin, had been detected in the drinking water. The warning stated that residents should not drink, boil, or even touch the contaminated water. A water crisis of this magnitude was recognized to pose a potentially serious and significant impact on patient care and safety in health care environments. ProMedica Toledo Hospital's Emergency Operation Plan addressed 3 critical issues: safe water availability, alternate cleaning solutions, and preparations for a prolonged crisis. This report details some of the lessons learned throughout the response to the crisis: particularly, because the impact was county-wide which affected other hospitals who used the same vendors, alternate water sources should have been secured in advance; the courier service was vital to delivery of supplies and moving equipment to alternate areas for sterilization processes; and finally, communication with staff and patients was jeopardized by external media outlets. Changes to the emergency plan considering these unanticipated aspects proved useful in a later incident and should be considered by all health care facilities as water emergency policies and procedures are created and reviewed. (Disaster Med Public Health Preparedness. 2018;page 1 of 3).

  7. The mother-daughter love affair across the generations.

    Science.gov (United States)

    Klockars, L; Sirola, R

    2001-01-01

    The relationship between mother and daughter is the basis for all love relationships throughout life. Through the eyes and hands of the mother, the intimate and caring nature of love is transmitted from generation to generation. Mother-daughter love is also the beginning of heterosexual love and of sensual pleasure. However, sexuality separates and alienates mother and daughter. As a consequence, the daughter's identification with the mother becomes the most important transmitter of love. We review psychoanalytic studies of the development and fate of the mother-daughter love relationship, with particular attention to the change of the daughter's early love for the mother to identification with the mother and falling in love with a man, and to the significance of sexuality in this developmental process.

  8. "Is the doctor God to punish me?!" An intersectional examination of disrespectful and abusive care during childbirth against single mothers in Tunisia.

    Science.gov (United States)

    Amroussia, Nada; Hernandez, Alison; Vives-Cases, Carmen; Goicolea, Isabel

    2017-03-04

    Disrespectful and abusive treatment during childbirth is a violation of women's right to dignified, respectful healthcare throughout pregnancy and childbirth. Although reports point out that marginalized groups in society such as single mothers are particularly vulnerable to abusive and disrespectful care, there is a lack of in-depth research exploring single mothers' encounters at the maternal healthcare facilities, especially in Tunisia. In Tunisia, single mothers are particularly vulnerable due to their social stigmatization and socio-economic marginalization. This study examines the self-perceptions and childbirth experiences of single mothers at the public healthcare facilities in Tunisia. This study follows a qualitative design. Eleven single mothers were interviewed in regard to their experiences with maternal healthcare services and their perceptions of the attitudes of the health workers towards them. The interviews also addressed the barriers faced by the participants in accessing adequate maternal healthcare services, and their self-perceptions as single mothers. The data were analyzed using an inductive thematic approach guided by the feminist intersectional approach. Emergent codes were grouped into three final themes. Three themes emerged during the data analysis: 1) Experiencing disrespect and abuse, 2) Perceptions of regret and shame attributed to being a single mother, and 3) The triad of vulnerability: stigma, social challenges, and health system challenges. The study highlights that the childbirth experiences of single mothers are shaped by intersectional factors that go beyond the health system. Gender plays a major role in constructing these experiences while intersecting with other social structures. The participants had experienced disrespectful and discriminatory practices and even violence when they sought maternal healthcare services at the public healthcare facilities in Tunisia. Those experiences reflect not only the poor quality of

  9. Mothers' AdvocateS In the Community (MOSAIC- non-professional mentor support to reduce intimate partner violence and depression in mothers: a cluster randomised trial in primary care

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    Gold Lisa

    2011-03-01

    Full Text Available Abstract Background Effective interventions to increase safety and wellbeing of mothers experiencing intimate partner violence (IPV are scarce. As much attention is focussed on professional intervention, this study aimed to determine the effectiveness of non-professional mentor support in reducing IPV and depression among pregnant and recent mothers experiencing, or at risk of IPV. Methods MOSAIC was a cluster randomised trial in 106 primary care (maternal and child health nurse and general practitioner clinics in Melbourne, Australia. 63/106 clinics referred 215 eligible culturally and linguistically diverse women between January 2006 and December 2007. 167 in the intervention (I arm, and 91 in the comparison (C arm. 174 (80.9% were recruited. 133 (76.4% women (90 I and 43 C completed follow-up at 12 months. Intervention: 12 months of weekly home visiting from trained and supervised local mothers, (English & Vietnamese speaking offering non-professional befriending, advocacy, parenting support and referrals. Main outcome measures: Primary outcomes; IPV (Composite Abuse Scale CAS and depression (Edinburgh Postnatal Depression Scale EPDS; secondary measures included wellbeing (SF-36, parenting stress (PSI-SF and social support (MOS-SF at baseline and follow-up. Analysis: Intention-to-treat using multivariable logistic regression and propensity scoring. Results There was evidence of a true difference in mean abuse scores at follow-up in the intervention compared with the comparison arm (15.9 vs 21.8, AdjDiff -8.67, CI -16.2 to -1.15. There was weak evidence for other outcomes, but a trend was evident favouring the intervention: proportions of women with CAS scores ≥7, 51/88 (58.4% vs 27/42 (64.3% AdjOR 0.47, CI 0.21 to 1.05; depression (EPDS score ≥13 (19/85, 22% (I vs 14/43, 33% (C; AdjOR 0.42, CI 0.17 to 1.06; physical wellbeing mean scores (PCS-SF36: AdjDiff 2.79; CI -0.40 to 5.99; mental wellbeing mean scores (MCS-SF36: AdjDiff 2.26; CI -1

  10. Mother-grandmother coparenting relationships in families with incarcerated mothers: a pilot investigation.

    Science.gov (United States)

    Baker, Jason; McHale, James; Strozier, Anne; Cecil, Dawn

    2010-06-01

    Using new methods designed to assess coparenting between incarcerated mothers of preschool-aged children and the maternal grandmothers caring for the children during their absence, we examined relationships between coparenting quality during the mother's jail stay and both concurrent child behavior problems and later coparenting interactions following mothers' release and community reentry. Forty mother-grandmother dyads participated in joint coparenting discussions during the incarceration, with a smaller subset completing a parallel activity at home 1 month postrelease. Both women also participated in individual coparenting interviews during the incarceration, and reported on child behavior problems. Mother-grandmother coparenting interactions exhibited an overall structure similar to that documented in nuclear families, with population-specific dynamics also evident. The observational system demonstrated good interrater and internal reliability, and showed associations with maternal (but not grandmother) reports and descriptions of the coparenting relationship via interview. Greater coparenting relationship quality during incarceration was associated with fewer concurrent child externalizing behavior problems, and predicted more positive coparenting interactions postrelease. Findings suggest that the coparenting assessments were useful for understanding mother-grandmother coparenting relationships in these families and that importantly, these relationships were tied to children's functioning. Avenues for future research and considerations for intervention efforts are discussed.

  11. Ontario pharmacists' crisis over Bill 16: A missed opportunity?

    Science.gov (United States)

    Rosenthal, Meagen; Austin, Zubin; Tsuyuki, Ross T

    2012-01-01

    In 2010, the Ontario government brought forward Bill 16, which, among other things, removed pharmacists' professional allowances. While many would disagree with this unilateral action by the Ontario government, it also could have served as a crisis for change towards patient-centred care. We sought to examine the response of the pharmacy profession in Ontario to this crisis as it relates to the vision outlined in the Blueprint for Pharmacy. We systematically examined publicly available responses to Schedule 5 of Ontario's Bill 16 during the period from April to June 16, 2010. A rapid textual analysis of the data using tag or word clouds and a qualitative content analysis were performed on all of the data collected. The rapid textual analysis revealed that the most frequently used terms were "pharmacist," "pharmacy" and "professional allowances"; the least used were "layoffs," "service cuts" and "patient care." Content analysis revealed 4 themes: the desire to maintain the status quo of practice, a focus on the business of pharmacy, pharmacy stakeholders' perceptions of government's attitude towards the profession and changes to patient services. It is notable that patient care was almost completely absent from the discussion, a reflection that our profession has not embraced patient-centred care. This also represents a missed opportunity - a crisis that could have been used to move the profession towards the Blueprint's vision. We thought that the Blueprint had already achieved this consensus, but the Ontario experience has shown that this may not be the case.

  12. Child-care and feeding practices of urban middle class working and non-working Indonesian mothers: a qualitative study of the socio-economic and cultural environment.

    Science.gov (United States)

    Roshita, Airin; Schubert, Elizabeth; Whittaker, Maxine

    2012-07-01

    The double-burden problem of malnutrition in many developing countries is occurring against a backdrop of complex changes in the socio-economic and cultural environment. One such change is the increasing rate of female employment, a change that has attracted researchers to explore the possible relationships between maternal employment and child nutritional status. The present study employs a qualitative approach to explore the socio-economic and cultural environments that may influence child-care practices in families of working and non-working mothers with children of different nutritional status and types of domestic caregiver. It was conducted in Depok, a satellite city of Jakarta, Indonesia, and was designed as a case study involving 26 middle class families. The children were categorized as underweight, normal weight and obese, and caregivers were grouped as family and domestic paid caregivers. Twenty-six mothers and 18 caregivers were interviewed. Data were analysed by the constant comparative approach. The study identified five emerging themes, consisting of reason for working and not working, support for mother and caregivers, decision maker on child food, maternal self-confidence and access to resources. It confirmed that mothers and caregivers need support and adequate resources to perform child-care practices regardless of the child nutritional and maternal working status. Further research is required into how Indonesian mothers across a range of socio-economic strata can have increased options for quality child-care arrangements and support with child feeding. Additionally, this paper discussed the importance of enhanced dissemination of health information addressing both child underweight and obesity problems. © 2011 Blackwell Publishing Ltd.

  13. Bad thoughts: Brazilian women's responses to mothering while experiencing postnatal depression.

    Science.gov (United States)

    Santos, Hudson Pires Oliveira; Sandelowski, Margarete; Gualda, Dulce Maria Rosa

    2014-06-01

    this study explores Brazilian women's experiences of mothering of their infants while experiencing postnatal depression. a cross-language qualitative descriptive design. the sample was composed of 15 women diagnosed with postnatal depression in a psychiatric institute in São Paulo, Brazil. Open-ended interviews were conducted and the data underwent thematic analysis. 13 women worried that harm would come to their infants. Seven of these women self-identified as potential sources of harm, with two women physically hurting their infants. The remaining six women worried about unknown agents, such as disease, hurting their infants. In response to these bad thoughts, women mothered their infants in one of four ways: (1) transferred care, completely delegating this task to family members; (2) shared care, asking family members to share the responsibility; (3) sole care, having to look after their infants by themselves because they had no available family support; (4) and smother care, being hyper-vigilant, constantly watching their infants and not trusting infant care to anyone else. the bad thoughts influenced the women's adaptation to mothering their infants. Health professionals should assess these thoughts early in the postnatal period and the women's mothering responses for the protection of mother and child. © 2013 Published by Elsevier Ltd.

  14. CRISIS-DIAGNOSTICS IN ANTI-CRISIS MANAGEMENT

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    Gavrylenko Valentina

    2018-01-01

    Full Text Available Introduction. In today’s conditions of a changing market environment, uncertainty and risk, one of the main tasks of management is the timely detection of crisis symptoms and the development of measures aimed at preventing their negative impact on the activities of the enterprise. The purpose of this article is to determine the accounting and analytical information for the development of the model KRIZІS-diagnostics and ensure the effectiveness of its functioning in anti-crisis management. Results. The analysis of definition of the concept «KRIZІS-diagnostics» in the scientific literature is carried out. Multi-factor models for assessing the financial status and the diagnostics of enterprises bankruptcy for different countries are presented. The specified classification of management KRIZІS-diagnostics is specified. The stages and tasks of KRIZІS-diagnostics are determined. The sources of information, which are determinants of the early symptoms of the crisis and necessary for KRIZІS-diagnostics are indicated and the characteristic is also given. Qualitative and quantitative indicators that characterize the business processes of the enterprise and can be used to analyze the state of the enterprise in a changing environment for preventing the crisis are determined. Conclusions. This approach of identifying crisis symptoms in business processes is the basis for managing an enterprise to make strategic management decisions in order to prevent a crisis at its early stages. The development of KRIZІS-diagnostics as an information provision for anti-crisis management is the direction of further research.

  15. The impact of Crisis Communication on audience: A study based on plane crash

    OpenAIRE

    Chan, Calvin

    2007-01-01

    Organisational crises have now become as common as having a cold. Crises negatively affect the company's reputation and share price. Maintaining a reputation has today become paramount. Therefore, post-crisis communication is absolutely essential and has to be planned carefully. Poor crisis communication would leave the audience or the public with bad impression over the company. The poor crisis communication may even extend the bad impression over the whole industry. In responding to th...

  16. Mothers’ Part-time Employment: Associations with Mother and Family Well-being

    Science.gov (United States)

    Buehler, Cheryl; O’Brien, Marion

    2011-01-01

    The associations between mothers’ part-time employment and mother well-being, parenting, and family functioning were examined using seven waves of the NICHD Study of Early Child Care and Youth Development data (N = 1,364), infancy through middle childhood. Concurrent comparisons were made between families in which mothers were employed part time and both those in which mothers were not employed and those in which mothers were employed full time. Using multivariate analysis of covariance with extensive controls, results indicated that mothers employed part time had fewer depressive symptoms during the infancy and preschool years and better self-reported health at most time points than did nonemployed mothers. Across the time span studied, mothers working part time tended to report less conflict between work and family than those working full time. During their children’s preschool years, mothers employed part time exhibited more sensitive parenting than did other mothers, and at school age were more involved in school and provided more learning opportunities than mothers employed full time. Mothers employed part time reported doing a higher proportion of child care and housework than mothers employed full time. Part-time employment appears to have some benefits for mothers and families throughout the child-rearing years. PMID:22004432

  17. Financial crisis and crisis management in Sweden: Lessons for today

    OpenAIRE

    Jonung, Lars

    2009-01-01

    This paper gives an account of the Swedish financial crisis covering the period 1985-2000, dealing with financial deregulation and the boom in the late 1980s, the bust and the financial crisis in the early 1990s, the recovery from the crisis and the bank resolution policy adopted during the crisis. The paper focuses on three issues: the causes and consequences of the financial crisis, the policy response concerning bank resolution, and the applicability of the Swedish model of bank crisis man...

  18. Factors Related to Depressive Symptoms in Mothers of Technology-Dependent Children.

    Science.gov (United States)

    Toly, Valerie Boebel; Musil, Carol M

    2015-07-01

    Mothers caring for technology-dependent children at home often suffer clinically significant and unrecognized depressive symptoms. The study aim was to determine factors related to elevated depressive symptoms and provide information to target interventions that assists mothers in self-management of their mental health. Secondary data analysis from a descriptive, correlational study of 75 mothers was performed. Hierarchical multiple regression analysis results indicate that younger, unpartnered mothers with lower normalization efforts and personal resourcefulness, and less care hours, had increased depressive symptoms. The importance of personal resourcefulness and the potential for a resourcefulness training intervention to reduce depressive symptoms are discussed.

  19. Nine centuries waiting: The experiences of Iranians surrogacy commissioning mothers.

    Science.gov (United States)

    Zandi, Mitra; Vanaki, Zohreh; Shiva, Marziyeh; Mohammadi, Eesa

    2014-05-01

    There are a few studies about commissioning mothers' understanding from the surrogacy during 9 months of waiting for delivery in Iran and other countries. This study was conducted with an aim to explore and explain the nature of concerns (experiences) of commissioning mothers. A qualitative design with a conventional content analysis approach was used to gather and analyze the experiences of commissioning mothers. They were selected from Royan Research Centre and other infertility centers in Iran. After purposive sampling for the selection of the participants, unstructured interviews were held for data collection. Twenty-four unstructured interviews were conducted with 12 commissioning mothers, 2 surrogate mothers, and 2 infertility center social workers who directly and continuously dealt with these mothers. TWO MAIN THEMES EMERGED FROM THE DATA ANALYSIS: 1. cultural dilemma (consisting of three subthemes: Social taboo, concerns about disclosure to others and the child, concerns about altering maternal and child's identity, and 2. uncertain waiting (consisting of three subthemes: Concerns about health of fetus and surrogate, concerns about an unfamiliar surrogate, and concerns about lack of preparation for maternal role). The study reveals the importance of maternal emotional care in this group and introduces a new arena for nurses' activity. These findings help the mothers by nurses' activities in health care clinics and anywhere they deliver nursing care.

  20. Improving Therapeutic Relationships: Joint Crisis Planning for Individuals With Psychotic Disorders.

    Science.gov (United States)

    Farrelly, Simone; Lester, Helen; Rose, Diana; Birchwood, Max; Marshall, Max; Waheed, Waquas; Henderson, R Claire; Szmukler, George; Thornicroft, Graham

    2015-12-01

    Outcomes for individuals with psychosis remain far from acceptable. Recently, prominent psychiatrists have called for an improved understanding of the impact of social contexts, and how social contexts might influence the development and maintenance of mental health problems. A key social context for individuals with psychosis is the therapeutic relationship. As part of a trial of joint crisis planning in England, this qualitative study aimed to determine the mechanism through which joint crisis planning might affect the therapeutic relationship. Results suggest that routine processes in mental health care are affected by policy and organizational requirements for risk mitigation-aspects that undermine person-centered approaches. In contrast, strong therapeutic relationships are characterized by individualized care and reliable and respectful treatment. The Joint Crisis Plan intervention partially succeeded in reducing contextual influences on routine role enactments, facilitating the demonstration of respect and improving the therapeutic relationship. © The Author(s) 2015.

  1. The effect of the global financial crisis on preventable hospitalizations among the homeless in New York State.

    Science.gov (United States)

    White, Brandi; Ellis, Charles; Jones, Walter; Moran, William; Simpson, Kit

    2018-04-01

    Objective Periods of economic instability may increase preventable hospitalizations because of increased barriers to accessing primary care. For underserved populations such as the homeless, these barriers may be more pronounced due to limited resources in the health care safety net. This study examined the impact of the global financial crisis of 2007-2008 on access to care for the homeless in New York State. Methods Hospitalizations for ambulatory care sensitive conditions (ACSCs) were used as a proxy measure for primary care access. Admissions for ACSCs were identified in the New York State Inpatient Database from 2006 to 2012. Hospitalization rates for ACSCs were calculated for the homeless and nonhomeless. Multivariable linear regression was used to investigate the impact of the financial crisis on hospitalization rates for ACSCs. Results The findings indicate that during the financial crisis, homeless adults had significantly higher preventable hospitalizations than nonhomeless adults, and the uninsured homeless had significantly higher preventable hospitalizations when compared to other homeless subgroups. After the financial crisis, preventable hospitalizations for the homeless stabilized but remained at higher rates than those for the nonhomeless. Conclusions These findings are important to developing health policies designed to provide effective care for underserved population such as the homeless.

  2. Who Helps the Helpers? Social Support for Rape Crisis Advocates.

    Science.gov (United States)

    Houston-Kolnik, Jaclyn D; Odahl-Ruan, Charlynn A; Greeson, Megan R

    2017-08-01

    Secondary exposure to trauma may have negative effects on rape victim advocates' well-being. Self-care can help to mitigate these negative effects on advocates' well-being, and prior research suggests that social support is an especially important aspect of advocates' self-care. However, there is a lack of research on how rape crisis advocates access and receive social support in relationship to their advocacy work. Therefore, semistructured qualitative interviews were conducted with 15 rape crisis advocates who volunteered for a rape crisis center in Chicago to understand how they accessed social support from informal and formal support providers, and when they did receive support, what was helpful versus unhelpful. Data were analyzed using thematic content analysis. Results revealed that many advocates were able to seek out and receive positive instrumental and emotional social support that nurtured them and their work. However, advocates also experienced a variety of barriers to obtaining positive support from informal support providers, including fear of burdening providers and a reluctance or lack of preparedness of their support providers to speak about the issue. Advocates emphasized the need for rape crisis centers to provide resources for their informal social support systems in order to encourage helpful responses. In addition, advocates praised the rape crisis center for its built-in formal support structures, but also encouraged the organization to seek broader representation of persons from minority backgrounds among their advocates and mentors. Implications and future directions for research and rape crisis centers are also discussed. The present study highlights the importance of social support systems for advocates and potential barriers that may be addressed to reduce service provider burnout and vicarious trauma.

  3. Energy Consumption of Lactating Mothers: Current Situation and Problems

    Directory of Open Access Journals (Sweden)

    Sandra Fikawati

    2014-08-01

    Full Text Available Recommendations on the adequacy of nutrient intake indicate that lactating mothers have higher nutritional needs than do pregnant mothers. High nutrient intake is necessary to help mothers recover after childbirth, produce milk, and maintain the quantity and quality of breast milk. It also prevents maternal malnutrition. Research has shown, however, that the dietary energy consumption of mothers during lactation was significantly lower than that during pregnancy. The current study explored the factors associated with decreased nutritional intake during maternal lactation. The study was conducted in March–April 2013, and the subjects were mothers with infants aged >6 months. Results revealed that the factors causing low dietary energy consumption among breastfeeding mothers were poor nutritional knowledge and attitude toward high energy intake requirements during lactation, lack of time to cook and eat because of infant care, reduced consumption of milk and supplements, dietary restrictions and prohibitions, and suboptimal advice from midwives/health personnel. Beginning from the antenatal care visit, health personnel should conduct effective counseling on the importance of nutrient intake during lactation. Advice should be provided not only to mothers, but also to their families to enable them to thoroughly support the mothers as they breastfeed their infants.

  4. Crisis Communication and Management: Surviving a Public Relations Crisis

    Science.gov (United States)

    Eramo, Eric M.

    2009-01-01

    Crisis management, or crisis communication, is never a good thing for a business to experience. It is, however, a public relations' professional moment to shine and put their honed skills to good use. A good crisis management plan is not only action during the crisis but preparation and reflection. Hiring a PR firm that deals with crisis…

  5. We are mothers too: childbearing experiences of lesbian families.

    Science.gov (United States)

    Renaud, Michelle T

    2007-01-01

    To describe lesbians' personal and health care experiences of becoming pregnant, giving birth, and being mothers and comothers within the context of potentially oppressive family, social, and political structures. Critical ethnography. Participants' homes, lesbian mother support group, and prenatal clinics and hospitals in the Pacific Northwest. English-speaking self-identified lesbian women, including 21 interview and six focus-group participants and approximately 43 observed in a support group. In-depth open-ended interviews, focus group, and participant observation. Content/categorical analysis followed by discussion of the mother's stories and a critical conversation about lesbian mothering. The seven organizing themes are as follows: preparing the way: becoming ready; conception: you can't just fall into it; you can hear a heartbeat: pregnancy; birthing our babies; the work of mothers and mothers who work; families who sustain and families who oppose; and sources of support in everyday life. The first four are described in this article. Health care providers, policy makers, and the public can be better informed about the specific needs of childbearing lesbians.

  6. Traditional Postpartum Practices Among Malaysian Mothers: A Review.

    Science.gov (United States)

    Fadzil, Fariza; Shamsuddin, Khadijah; Wan Puteh, Sharifa Ezat

    2016-07-01

    To briefly describe the postpartum practices among the three major ethnic groups in Malaysia and to identify commonalities in their traditional postpartum beliefs and practices. This narrative review collated information on traditional postpartum practices among Malaysian mothers through a literature search for published research papers on traditional postpartum practices in Malaysia. This review shows that Malaysian mothers have certain postpartum practices that they considered to be important for preventing future ill health. Despite the perceived differences in intra-ethnic postpartum practices, most Malaysian mothers, although from different ethnicities, share similarities in their postpartum regimens and practices in terms of beliefs and adherence to food taboos, use of traditional postpartum massage and traditional herbs, and acknowledgment of the role of older female family members in postpartum care. Health care providers should be aware of multiethnic traditional postpartum practices and use the commonalities in these practices as part of their postpartum care regimen.

  7. Mothers' process of decision making for gastrostomy placement.

    Science.gov (United States)

    Brotherton, Ailsa; Abbott, Janice

    2012-05-01

    In this article we present the findings of an exploration of mothers' discourses on decision making for gastrostomy placement for their child. Exploring in-depth interviews of a purposive sample, we analyzed the mothers' discourses of the decision-making process to understand how their experiences of the process influenced their subsequent constructions of decision making. Mothers negotiated decision making by reflecting on their personal experiences of feeding their child, either orally or via a tube, and interwove their background experiences with the communications from members of the health care team until a decision was reached. Decision making was often fraught with difficulty, resulting in anxiety and guilt. Experiences of decision making ranged from perceived coercion to true choice, which encompasses a truly child-centered decision. The resulting impact of the decision-making process on the mothers was profound. We conclude with an exploration of the implications for clinical practice and describe how health care professionals can support mothers to ensure that decision-making processes for gastrostomy placement in children are significantly improved.

  8. Process of becoming a mother for Iranian surrogacy-commissioning mothers: A grounded theory study.

    Science.gov (United States)

    Zandi, Mitra; Vanaki, Zohreh; Shiva, Marziyeh; Mohammadi, Eesa

    2018-01-01

    Little knowledge is available about the experiences of the commissioning mothers during the process of surrogacy; thus, the present study was conducted in order to explore and analyze this process. This study was conducted in a referral institute in Tehran with a qualitative approach and using grounded theory methodology. The data were collected through 39 unstructured, in-depth interviews that were conducted with 15 gestational commissioning mothers, two of their husbands, four surrogates, and five of the personnel at centers for assisted reproduction (some participants were interviewed more than once). Sampling started purposively and then continued theoretically. The analysis revealed the main concern of these mothers to be the feeling of "insecurity about becoming a mother" and their predominant strategy for dealing with it to be "seeking security about becoming a mother," which emerged as a core concept. The consequences of the mothers' adopted strategies and the effects of the intervening factors included "reaching a state of relative peace," "a continuing threat to one's identity," and "mental and physical exhaustion." Identifying the demands of this group of mothers can help medical personnel, particularly nurses, adopt better plans for the future and to optimize the care they provide to these patients. © 2017 Japan Academy of Nursing Science.

  9. Maternal care, mother-offspring aggregation and age-dependent coadaptation in the European earwig.

    Science.gov (United States)

    Gómez, Y; Kölliker, M

    2013-09-01

    Benefits and costs of parental care are expected to change with offspring development and lead to age-dependent coadaptation expressed as phenotypic (behavioural) matches between offspring age and parental reproductive stage. Parents and offspring interact repeatedly over time for the provision of parental care. Their behaviours should be accordingly adjusted to each other dynamically and adaptively, and the phenotypic match between offspring age and parental stage should stabilize the repeated behavioural interactions. In the European earwig (Forficula auricularia), maternal care is beneficial for offspring survival, but not vital, allowing us to investigate the extent to which the stability of mother-offspring aggregation is shaped by age-dependent coadaptation. In this study, we experimentally cross-fostered nymphs of different age classes (younger or older) between females in early or late reproductive stage to disrupt age-dependent coadaptation, thereby generating female-nymph dyads that were phenotypically matched or mismatched. The results revealed a higher stability in aggregation during the first larval instar when care is most intense, a steeper decline in aggregation tendency over developmental time and a reduced developmental rate in matched compared with mismatched families. Furthermore, nymph survival was positively correlated with female-nymph aggregation stability during the early stages when maternal care is most prevalent. These results support the hypothesis that age-related phenotypically plastic coadaptation affects family dynamics and offspring developmental rate. © 2013 The Authors. Journal of Evolutionary Biology © 2013 European Society For Evolutionary Biology.

  10. An Exploration of Parenting Stress in Immigrant and Taiwanese Mothers.

    Science.gov (United States)

    Tsao, Ying; Creedy, Debra K; Gamble, Jenny

    2015-01-01

    To assess parenting stress and major difficulties experienced in early motherhood among immigrant and Taiwanese women in Pingtung, southern Taiwan. A comparative, descriptive, cohort study of parenting stress and maternal psychological health, using the Child Care Stress Checklist and Edinburgh Postpartum Depression Scale. A purposive sample of 26 foreign-born Vietnamese and 162 Taiwanese mothers were surveyed at 6 weeks' postpartum. Both groups of mothers experienced similar parenting difficulties including the establishment of a regular sleeping schedule for the infant, consoling a crying infant, awareness of infant's needs, conflict with family members, and difficulties managing household chores. Curtailment of social activities was reported more often by Taiwanese mothers, whereas inaccessibility to other experienced mothers and poor maternal-infant bonding were experienced more by immigrant mothers. There were significant differences between groups, with high levels of child care stress and postpartum depression symptoms reported more often by immigrant mothers. Nurses-midwives and community child health nurses need to be sensitive to the particular difficulties and stresses of parenting in mothers from different backgrounds and provide effective interventions and support activities.

  11. The effect of educational program on stress, anxiety and depression of the mothers of neonates having colostomy.

    Science.gov (United States)

    Goudarzi, Zahra; Askari, Masoumeh; Seyed-Fatemi, Naiemeh; Asgari, Parvaneh; Mehran, Abbas

    2016-12-01

    One of the problems that mothers of neonates having colostomy face is their disability in caring colostomy at home. This article is going to demonstrate the impact of educational program for these mothers on their sense of empowerment in caring their neonates. This clinical trial was performed in the Neonatal Intensive Care Units (NICUs) to evaluate the level of stress, anxiety and depression of mothers of neonates having colostomy before and after the educational program. In this program, 42 mothers were divided into two groups: experimental group (21 mothers who went under educational plan) and control group (21 mothers who only received the routine care). The levels of stress, anxiety and depression in all mothers were evaluated before and after the educational program with DASS 21 questionnaire. The results showed that educational program in the NICU for experimental groups made them independent and also empowered to care better for their babies. In addition, their depression, anxiety and stress levels were decreased. Since the educational program led to a decrease in the levels of stress, anxiety and depression in mothers, this program is recommended to mothers of neonates having colostomy.

  12. EXPLAINING THE GAP IN ANTENATAL CARE SERVICE UTILIZATION BETWEEN YOUNGER AND OLDER MOTHERS IN GHANA.

    Science.gov (United States)

    Boamah, Sheila A; Amoyaw, Jonathan; Luginaah, Isaac

    2016-05-01

    Over two-thirds of pregnant women (69%) have at least one antenatal care (ANC) coverage contact in sub-Saharan Africa. However, to achieve the full life-saving potential that ANC promises for women and babies, a nuanced understanding of age-specific gaps in utilization of ANC services is required. Using the 2008 Ghana Demographic and Health Survey of 1456 individuals, this study examined the disparities in the use of ANC services between younger and older mothers by applying four counterfactual decomposition techniques. The results show that cross-group differences in the explanatory variables largely account for the differentials in ANC service utilization between younger and older mothers. Birth order (parity) accounts for the largest share of the contribution to the overall explained gap in ANC utilization between the younger and older mothers, suggesting that ANC differentials between the two groups are probably due to biosocial factors. To a lesser extent, wealth status of the two groups also contributes to the overall explained gap in ANC service utilization. The policy implications of these findings are that in order to bridge the ANC service utilization gap between the two groups, policymakers must systematically address gaps in cross-group differences in the explanatory variables in order to increase the utilization of ANC to attain the minimum recommendation of four visits as per World Health Organization guidelines.

  13. Understanding the meaning and role of gifts given to Ugandan mothers in maternity care settings: 'The help they give when they've seen how different you are'.

    Science.gov (United States)

    Rudrum, Sarah; Brown, Helen; Oliffe, John L

    2016-11-01

    The provision of gifts to new mothers in Uganda is laden with significance that varies by the social location of the giver and receiver and the context and conditions under which the gift is made available. Here, we examine the act of gift giving and receiving within a Ugandan maternity care setting, describing the connections between these material objects and social relations. A study investigating the social organisation of maternity care in post-conflict northern Uganda found that gift-giving to new mothers functioned to create a material and discursive context wherein women's desire to access these goods was leveraged to create an incentive to attend formal maternity care during pregnancy and for delivery. In this article we describe the material and discursive processes surrounding gift-giving to new mothers in this global South health care setting. This article contributes critical analyses of the function of gifts in healthcare settings as constructing shared identities, social differences and normative values about health citizenship, and an incentive politic that affects equitable access to maternity care. Drawing on intersectional theory and analysis of how specific practices function ideologically to reward or incentivise pregnant women, we integrate material culture studies into the sociology of women's reproductive health. © 2016 Foundation for the Sociology of Health & Illness.

  14. A Novel Mental Health Crisis Service - Outcomes of Inpatient Data.

    Science.gov (United States)

    Morrow, R; McGlennon, D; McDonnell, C

    2016-01-01

    Northern Ireland has high mental health needs and a rising suicide rate. Our area has suffered a 32% reduction of inpatient beds consistent with the national drive towards community based treatment. Taking these factors into account, a new Mental Health Crisis Service was developed incorporating a high fidelity Crisis Response Home Treatment Team (CRHTT), Acute Day Care facility and two inpatient wards. The aim was to provide alternatives to inpatient admission. The new service would facilitate transition between inpatient and community care while decreasing bed occupancy and increasing treatment in the community. All services and processes were reviewed to assess deficiencies in current care. There was extensive consultation with internal and external stakeholders and process mapping using the COBRAs framework as a basis for the service improvement model. The project team set the service criteria and reviewed progress. In the original service model, the average inpatient occupancy rate was 106.6%, admission rate was 48 patients per month and total length of stay was 23.4 days. After introducing the inpatient consultant hospital model, the average occupancy rate decreased to 90%, admissions to 43 per month and total length of stay to 22 days. The results further decreased to 83% occupancy, 32 admissions per month and total length of stay 12 days after CRHTT initiation. The Crisis Service is still being evaluated but currently the model has provided safe alternatives to inpatient care. Involvement with patients, carers and all multidisciplinary teams is maximised to improve the quality and safety of care. Innovative ideas including structured weekly timetable and regular interface meetings have improved communication and allowed additional time for patient care.

  15. Health care professionals' perspectives on the requirements facilitating the roll-out of kangaroo mother care in South Africa

    Directory of Open Access Journals (Sweden)

    Wilma ten Ham

    2016-10-01

    Purpose of the research: To explore and describe the perspectives of health professionals on the requirements for the rolling-out process of KMC as a best practice in South Africa. Methodology: Twelve semi-structured individual interviews were conducted in 2012 with health professionals from various South African healthcare levels, involved in the implementation and the rolling-out process of kangaroo mother care. Content analysis were guided in terms of the four requirements for roll-out of best practices, identified in Edwards and Grinspun's Evidence Informed Model of Care. Results: The requirements for the successful rollout of best practices mentioned by the participants in this study concur with the requirements of Edwards and Grinspun: personal alignment and protocol/policy alignment with the best practice; a roll-out plan; leadership; and supporting and reinforcing structures such as: resources, communicating, education and development regarding the best practice, and the organisational structure. The requirements were identified at four different levels: individual level (e.g. the nurse and medical specialists, management level (of the hospital, provincial level and national level.

  16. Delivery of HIV care during the 2007 post-election crisis in Kenya: a case study analyzing the response of the Academic Model Providing Access to Healthcare (AMPATH) program.

    Science.gov (United States)

    Goodrich, Suzanne; Ndege, Samson; Kimaiyo, Sylvester; Some, Hosea; Wachira, Juddy; Braitstein, Paula; Sidle, John E; Sitienei, Jackline; Owino, Regina; Chesoli, Cleophas; Gichunge, Catherine; Komen, Fanice; Ojwang, Claris; Sang, Edwin; Siika, Abraham; Wools-Kaloustian, Kara

    2013-12-01

    Widespread violence followed the 2007 presidential elections in Kenya resulting in the deaths of a reported 1,133 people and the displacement of approximately 660,000 others. At the time of the crisis the United States Agency for International Development-Academic Model Providing Access to Healthcare (USAID-AMPATH) Partnership was operating 17 primary HIV clinics in western Kenya and treating 59,437 HIV positive patients (23,437 on antiretroviral therapy (ART)). This case study examines AMPATH's provision of care and maintenance of patients on ART throughout the period of disruption. This was accomplished by implementing immediate interventions including rapid information dissemination through the media, emergency hotlines and community liaisons; organization of a Crisis Response leadership team; the prompt assembly of multidisciplinary teams to address patient care, including psychological support staff (in clinics and in camps for internally displaced persons (IDP)); and the use of the AMPATH Medical Records System to identify patients on ART who had missed clinic appointments. These interventions resulted in the opening of all AMPATH clinics within five days of their scheduled post-holiday opening dates, 23,949 patient visits in January 2008 (23,259 previously scheduled), uninterrupted availability of antiretrovirals at all clinics, treatment of 1,420 HIV patients in IDP camps, distribution of basic provisions, mobilization of outreach services to locate missing AMPATH patients and delivery of psychosocial support to 300 staff members and 632 patients in IDP camps. Key lessons learned in maintaining the delivery of HIV care in a crisis situation include the importance of advance planning to develop programs that can function during a crisis, an emphasis on a rapid programmatic response, the ability of clinics to function autonomously, patient knowledge of their disease, the use of community and patient networks, addressing staff needs and developing effective

  17. ESRD in the geriatric population: the crisis of managed care and the opportunity of disease management.

    Science.gov (United States)

    Steinman, Theodore I

    2002-01-01

    The geriatric population with end-stage renal disease (ESRD) is placed at risk with regards to the quality and extent of medical coverage because of the rapidly changing financial environment. Managed care organizations (MCOs) are generally for-profit companies that must focus on the bottom line. While the verbal commitment to quality care is voiced, the financial pressures on MCOs have led to a decrease in coverage of many services and outright denial for some necessary treatments. While denying services, the MCOs have also reduced payments to providers for services rendered. The coverage crisis is compounded by health maintenance organizations (HMOs) quitting Medicare because the reimbursement from the Health Care Financing Administration (HCFA) is less than their costs. Because of the above issues which can potentially impact on the quality of care delivered to the ESRD geriatric population, a new approach to disease management has created the opportunity to improve total patient care to a level not yet achieved in the United States. Disease management encompasses integrated care across all disciplines. Every component of care can be tracked by a dedicated information system. Improvement in outcomes has far exceeded the U.S. Renal Data System (USRDS) benchmark performance measurements with a disease management model approach. The key to success is the health service coordinator (HSC), a senior nurse with many years of ESRD experience. This individual coordinates care across all disciplines and expedites necessary referrals. With rapid attention to patient needs there has been a significant reduction in hospital admissions, hospital length of stay, and emergency room visits. Patient care will steadily improve as the disease management system matures as a consequence of understanding the patients total physical and psychosocial needs.

  18. Starting the conversation: community perspectives on preterm birth and kangaroo mother care in southern Malawi.

    Science.gov (United States)

    Lydon, Megan; Longwe, Monica; Likomwa, Dyson; Lwesha, Victoria; Chimtembo, Lydia; Donohue, Pamela; Guenther, Tanya; Valsangar, Bina

    2018-06-01

    Despite introduction of Kangaroo Mother Care (KMC) in Malawi over a decade ago, preterm birth remains the leading cause of neonatal mortality. Although KMC is initiated in the health care facility, robust community follow-up is critical for survival and optimal development of preterm and low birth weight infants post-discharge. The objective of this qualitative study was to gain insight into community and health worker understanding, attitudes, beliefs and practices around preterm and low birth weight babies and KMC in Malawi. A total of 152 participants were interviewed in two districts in southern Malawi, Machinga and Thyolo, in April 2015. Focus group discussions (groups = 11, n = 132) were conducted with pregnant women, community members and women who have practiced KMC. In-depth interviews (n = 20) were conducted with fathers who have practiced KMC, community and religious leaders, and health workers. Purposive and snowball sampling were employed to identify participants. Thematic content analysis was conducted. KMC mothers and fathers only learned about KMC and care for preterm newborns after delivery of a child in need of this care. Men typically were not included in KMC counseling due to societal gender roles. Health facilities were the main source of information on KMC, however informal networks among women provided some degree of knowledge exchange. Community leaders were regarded as major facilitators of health information, conveners, key influencers, and policy-makers. Religious leaders were regarded as advocates and emotional support for families with preterm infants. Finally, while many participants initially had negative feelings towards preterm births and KMC, the large majority saw a shift in their perceptions through health counseling, peer modeling, and personal success with KMC. The findings offer several opportunities to improve KMC implementation including 1) earlier introduction of KMC to pregnant women and their families that are

  19. Impact of the east Asian economic crisis on health and health care: Malaysia's response.

    Science.gov (United States)

    Suleiman, A B; Lye, M S; Yon, R; Teoh, S C; Alias, M

    1998-01-01

    In the wake of the east Asian economic crisis, the health budget for the public sector in Malaysia was cut by 12%. The Ministry of Health responded swiftly with a series of broad-based and specific strategies. There was a careful examination of the operating expenditure and where possible measures were taken to minimise the effects of the budget constraints at the service interface. The MOH reprioritised the development of health projects. Important projects such as rural health projects and training facilities, and committed projects, were continued. In public health, population-based preventive and promotive activities were expected to experience some form of curtailment. There is a need to refocus priorities, maximise the utilisation of resources, and increase productivity at all levels and in all sectors, both public and private, in order to minimise the impact of the economic downturn on health.

  20. Evaluation of the Effect of Sociodemographic Characteristics on the Satisfaction of Mothers in Neonatal Intensive Care Units in Turkey

    Directory of Open Access Journals (Sweden)

    Fatma Yılmaz

    2016-03-01

    Full Text Available Background: Patient and parent satisfaction is a significant indicator for the evaluation of quality of care in healthcare systems. This study aimed to evaluate the effect of sociodemographic characteristics on the satisfaction of the parents of newborns admitted in neonatal intensive care units (NICUs in maternity and infant disease hospitals. Methods: This descriptive study was conducted on 113 mothers with infants admitted in the NICU of a state hospital in Turkey during April 1-September 30, 2013.Data were collected using sociodemographic questionnaire and Pediatric Quality of Life Inventory (PedsQL healthcare satisfaction scale. Data analysis was performed using descriptive statistics (mean and percentage, T-test, Mann-Whitney U test, and Kruskal-Wallis test. Results: In this study, mean score of maternal satisfaction with NICU services was 65.66±20.01. No statistically significant differences were observed between maternal age, PedsQL satisfaction subscales, and total score of satisfaction. Moreover, statistically significant associations were observed between the following variables: maternal training and total satisfaction, employment status and subscales of PedsQL, technical skills and general satisfaction, and social security status and emotional support. However, no statistically significant differences were observed between the sociodemographic characteristics of newborns, total score of satisfaction, and mean scores of PedsQL satisfaction subscales in mothers. Conclusion: According to the results of this study, level of maternal satisfaction with NICU services was higher than the international average. Therefore, it is recommended that NICU nurses offer sufficient emotional support for both mothers and neonates in this unit and allow mothers to stay with their infants during hospitalization. Furthermore, it is suggested that training programs be implemented on effective communication skills between nurses and patients.

  1. [Development and evaluation of an e-learning program for mothers of premature infants].

    Science.gov (United States)

    Lee, Nae-Young; Kim, Young-Hae

    2008-02-01

    It has been attempted to support mother of premature infants by providing information of premature infant care using e-learning because premature infants need continuous care from birth to after discharge. The e-Learning Program for mother of premature was developed with Xpert, Namo web editor, Adobe Photoshop, and PowerPoint and applied for 4 weeks from 4 to 30 September 2006. 1) We found that the contents of information which premature infants' need when being in the hospital and after discharge were the definition of a premature infant, orientation of NICU, care of premature infants, care of premature infants' common diseases, the connection of healthcare resources, exchange of information, and the management of rearing stress. 2) The program content consisted of cause of premature birth, comparison to full-term baby, physiology character, orientation of NICU, common health problems, follow up care, infection control, feeding, normal development physically and mentally, weaning method, and vaccination. Considering the results, this program for mother of premature is a useful means to provide premature-care information to mothers. This information can be readily accessible and can be varied and complex enough to be able to help mothers to the information and assistance they require.

  2. Pediatric-based intervention to motivate mothers to seek follow-up for depression screens: The Motivating Our Mothers (MOM) trial.

    Science.gov (United States)

    Fernandez y Garcia, Erik; Joseph, Jill; Wilson, Machelle D; Hinton, Ladson; Simon, Gregory; Ludman, Evette; Scott, Fiona; Kravitz, Richard L

    2015-01-01

    To determine the initial effectiveness of a novel, pediatric office-based intervention in motivating mothers to seek further assessment of positive depression screens. In this pilot randomized controlled trial, English-speaking mothers (n = 104) with positive 2-question depression screens and presenting with children 0 to 12 years old for well-child care to a general pediatric training clinic received interventions from a trained research assistant. The Motivating Our Mothers (MOM) intervention included office-based written and verbal targeted depression education and motivational messages encouraging further depression assessment and a semistructured telephone booster delivered 2 days later. The control intervention included nontargeted written and verbal messages and 2 days later, an attention control telephone survey. Both groups received a list of depression care resources. The primary outcome was the proportion of mothers in each group who reported trying to contact any of 6 types of resources to discuss the positive screen at 2 weeks after intervention (ClinicalTrials.gov NCT01453790). Despite 6 contact attempts, 10 MOM and 9 control mothers were lost to follow-up. More mothers in the MOM intervention tried to contact a resource compared to control (73.8% vs 53.5%, difference 20.3%, 95% confidence interval for difference -0.1 to 38.5, P = .052). Mothers receiving the MOM intervention made more attempts to contact a resource for follow-up of positive depression screens. If found effective in larger studies, MOM may prove a promising approach for motivating depression screen-positive mothers identified in general pediatric settings within and beyond the postpartum period to seek further depression assessment and support. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  3. Mentor mother support for mothers experiencing intimate partner violence in family practice: A qualitative study of three different perspectives on the facilitators and barriers of implementation.

    Science.gov (United States)

    Loeffen, Maartje J W; Daemen, Jasper; Wester, Fred P J F; Laurant, Miranda G H; Lo Fo Wong, Sylvie H; Lagro-Janssen, Antoine L M

    2017-12-01

    Intimate partner violence (IPV) is highly prevalent and associated with physical and mental health problems. Mentor mother support is a low threshold intervention in family practice consisting of support by non-professionals trained to support mothers experiencing IPV. A mentor mother support study showed reduced exposure to IPV and decreased symptoms of depression. Identify factors determining implementation success of mentor mother support in family practice. Individual interviews were conducted with 12 family physicians, 16 abused mothers and three mentor mothers. Four mentor mothers participated in a focus group. Qualitative content analysis was used to analyse the data. The identification and discussion of abuse is hindered by family physicians' attitudes because they considered mothers experiencing IPV as a difficult target group with a responsibility of their own to break out of their violent situation. Some family physicians doubted the partner's violence because he was known as a patient as well. Acceptance of mentor mother support is related to the readiness for change of mothers experiencing IPV. Mentor mothers facilitate acceptance and completion of their support by connecting as a friend who is equal and less threatening than professionals. To improve successful implementation of mentor mother support in primary care, we should focus on family physicians' attitudes towards IPV. To change these attitudes, we recommend continuous training of family physicians. By being paraprofessional friends, mentor mothers offer low threshold support that is complementary to professional support and should be embedded more widely in primary care. [Box: see text].

  4. Good short-term outcomes of kangaroo mother care in infants with a ...

    African Journals Online (AJOL)

    This descriptive study included 87 mothers and their low birth weight infants who were ... Department of Family Medicine, Faculty of Health Sciences, University of the Free ... mother was unwilling to participate. ... Child can be without oxygen for most of the day .... are related to both gestational age and ... mother intervention.

  5. Video feedback promotes relations between infants and vulnerable first-time mothers

    DEFF Research Database (Denmark)

    Kristensen, Ingeborg Hedegaard; Simonsen, Marianne; Trillingsgaard, Tea

    2017-01-01

    BACKGROUND: Supporting early mother-infant relationships to ensure infants' future health has been recommended. The aim of this study was to investigate whether video feedback using the Marte Meo method promotes a healthy early relationship between infants and vulnerable first-time mothers. Video...... feedback or usual care was delivered by health visitors during home visits in Danish municipalities. METHODS: This quasi-experimental study included pre- and post-tests of 278 vulnerable families. Mothers were allocated to an intervention group (n = 69), a comparison group (n = 209) and an exactly matched...... video subsample from the comparison group (n = 63). Data consisted of self-reported questionnaires and video recordings of mother-infant interactions. Outcomes were mother-infant dyadic synchrony (CARE-Index), maternal confidence (KPCS), parental stress (PSS), maternal mood (EPDS) and infant...

  6. Crisis? What crisis? How European professionals handle crises and crisis communication

    NARCIS (Netherlands)

    Verhoeven, P.; Tench, R.; Zerfass, A.; Moreno, A.; Verčič, D.

    2014-01-01

    A broad study in 43 European countries shows that 70% of communication professionals encounter at least one crisis a year, mostly institutional, related to the performance of the organization or a crisis in management or leadership. Organizational response and image restoration approaches are mainly

  7. An official American Thoracic Society workshop report: assessment and palliative management of dyspnea crisis.

    Science.gov (United States)

    Mularski, Richard A; Reinke, Lynn F; Carrieri-Kohlman, Virginia; Fischer, Mark D; Campbell, Margaret L; Rocker, Graeme; Schneidman, Ann; Jacobs, Susan S; Arnold, Robert; Benditt, Joshua O; Booth, Sara; Byock, Ira; Chan, Garrett K; Curtis, J Randall; Donesky, Doranne; Hansen-Flaschen, John; Heffner, John; Klein, Russell; Limberg, Trina M; Manning, Harold L; Morrison, R Sean; Ries, Andrew L; Schmidt, Gregory A; Selecky, Paul A; Truog, Robert D; Wang, Angela C C; White, Douglas B

    2013-10-01

    In 2009, the American Thoracic Society (ATS) funded an assembly project, Palliative Management of Dyspnea Crisis, to focus on identification, management, and optimal resource utilization for effective palliation of acute episodes of dyspnea. We conducted a comprehensive search of the medical literature and evaluated available evidence from systematic evidence-based reviews (SEBRs) using a modified AMSTAR approach and then summarized the palliative management knowledge base for participants to use in discourse at a 2009 ATS workshop. We used an informal consensus process to develop a working definition of this novel entity and established an Ad Hoc Committee on Palliative Management of Dyspnea Crisis to further develop an official ATS document on the topic. The Ad Hoc Committee members defined dyspnea crisis as "sustained and severe resting breathing discomfort that occurs in patients with advanced, often life-limiting illness and overwhelms the patient and caregivers' ability to achieve symptom relief." Dyspnea crisis can occur suddenly and is characteristically without a reversible etiology. The workshop participants focused on dyspnea crisis management for patients in whom the goals of care are focused on palliation and for whom endotracheal intubation and mechanical ventilation are not consistent with articulated preferences. However, approaches to dyspnea crisis may also be appropriate for patients electing life-sustaining treatment. The Ad Hoc Committee developed a Workshop Report concerning assessment of dyspnea crisis; ethical and professional considerations; efficient utilization, communication, and care coordination; clinical management of dyspnea crisis; development of patient education and provider aid products; and enhancing implementation with audit and quality improvement.

  8. SARS: Key factors in crisis management.

    Science.gov (United States)

    Tseng, Hsin-Chao; Chen, Thai-Form; Chou, Shieu-Ming

    2005-03-01

    This study was conducted at a single hospital selected in Taipei during the SARS (Severe Acute Respiratory Syndrome) outbreak from March to July, 2003 in Taiwan. During this period of time, 104 SARS patients were admitted to the hospital. There were no negative reports related to the selected hospital despite its being located right in the center of an area struck by the epidemic. The purpose of this study was to identify the key factors enabling the hospital to survive SARS unscathed. Data were collected from in-depth interviews with the nursing directors and nursing managers of the SARS units, along with a review of relevant hospital documents. The five key elements identified as survival factors during this SARS crisis are as follows: 1. good control of timing for crisis management, 2. careful decision-making, 3. thorough implementation, 4. effective communication, and 5. trust between management and employees. The results of this study reconfirmed the selected hospital as a model for good crisis management during the SARS epidemic.

  9. Crying babies, tired mothers - challenges of the postnatal hospital stay: an interpretive phenomenological study

    Directory of Open Access Journals (Sweden)

    Biedermann Johanna

    2010-05-01

    Full Text Available Abstract Background According to an old Swiss proverb, "a new mother lazing in childbed is a blessing to her family". Today mothers rarely enjoy restful days after birth, but enter directly into the challenge of combining baby- and self-care. They often face a combination of infant crying and personal tiredness. Yet, routine postnatal care often lacks effective strategies to alleviate these challenges which can adversely affect family health. We explored how new mothers experience and handle postnatal infant crying and their own tiredness in the context of changing hospital care practices in Switzerland. Methods Purposeful sampling was used to enroll 15 mothers of diverse parity and educational backgrounds, all of who had given birth to a full term healthy neonate. Using interpretive phenomenology, we analyzed interview and participant observation data collected during the postnatal hospital stay and at 6 and 12 weeks post birth. This paper reports on the postnatal hospital experience. Results Women's personal beliefs about beneficial childcare practices shaped how they cared for their newborn's and their own needs during the early postnatal period in the hospital. These beliefs ranged from an infant-centered approach focused on the infant's development of a basic sense of trust to an approach that balanced the infants' demands with the mother's personal needs. Getting adequate rest was particularly difficult for mothers striving to provide infant-centered care for an unsettled neonate. These mothers suffered from sleep deprivation and severe tiredness unless they were able to leave the baby with health professionals for several hours during the night. Conclusion New mothers often need permission to attend to their own needs, as well as practical support with childcare to recover from birth especially when neonates are fussy. To strengthen family health from the earliest stage, postnatal care should establish conditions which enable new mothers

  10. A qualitative study on knowledge, perceptions, and attitudes of mothers and health care providers toward pneumococcal conjugate vaccine in Bandung, West Java, Indonesia.

    Science.gov (United States)

    Harjaningrum, Agnes Tri; Kartasasmita, Cissy; Orne-Gliemann, Joanna; Jutand, Marthe-Aline; Goujon, Nicolas; Koeck, Jean-Louis

    2013-03-01

    Due to the high burden of pneumonia in Indonesia, the inclusion of pneumococcal conjugate vaccine (PCV) into Indonesia's National Immunization Program (NIP) is recommended by World Health Organization. Prior to the introduction of new vaccines, it is imperative to assess the perceptions of the public and medical community about the disease and the vaccine. The purpose of this qualitative study was to explore the knowledge, perceptions, and attitudes of mothers and health care providers (HCPs) toward PCV in Bandung, West Java, Indonesia. Fifty-five respondents (26 mothers and 29 HCPs) were interviewed at public and private health care facilities in Bandung using semi-structured interviews in May-June 2011. Data were analyzed manually according to pre-defined themes. Although most mothers had low knowledge about PCV, did not perceive themselves as susceptible to the disease, perceived that cost was the main barrier to PCV access, and obtained little information on PCV, they considered pneumonia as a severe disease and a priority health problem, perceived benefits of the vaccine, and were likely to adopt it. Similarly, knowledge about PCV among most HCPs was limited. Despite perceiving cost as the main barrier, most HCPs perceived benefits of the vaccine, susceptibility and severity of the disease, regarded pneumonia as a priority health problem, and were likely to suggest the new vaccination. Despite the poor knowledge of mothers and HCPs about PCV, they are aware of the high burden of pneumonia and the need for a vaccine in the NIP. Perceived severity and benefits among mothers, and, additionally, perceived susceptibility among HCPs were manifested in the willingness to accept PCV. The findings would contribute to better understanding the factors, which could support decision-making about vaccine introduction, and be utilized for developing suitable messages for mothers and HCPs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Dental care coverage and income-related inequalities in foregone dental care in Europe during the great recession.

    Science.gov (United States)

    Elstad, Jon Ivar

    2017-08-01

    This study examines income inequalities in foregone dental care in 23 European countries during the years with global economic crisis. Associations between dental care coverage from public health budgets or social insurance, and income-related inequalities in perceived access to dental care, are analysed. Survey data 2008-2013 from 23 countries were combined with country data on macro-economic conditions and coverage for dental care. Foregone dental care was defined as self-reported abstentions from needed dental care because of costs or other crisis-related reasons. Age-standardized percentages reporting foregone dental care were estimated for respondents, age 20-74, in the lowest and highest income quartile. Associations between dental care coverage and income inequalities in foregone dental care, adjusted for macro-economic indicators, were examined by country-level regression models. In all 23 countries, respondents in the lowest income quartile reported significantly higher levels of foregone dental care than respondents in the highest quartile. During 2008-2013, income inequalities in foregone dental care widened significantly in 13 of 23 countries, but decreased in only three countries. Adjusted for countries' macro-economic situation and severity of the economic crisis, higher dental care coverage was significantly associated with smaller income inequalities in foregone dental care and less widening of these inequalities. Income-related inequalities in dental care have widened in Europe during the years with global economic crisis. Higher dental care coverage corresponded to less income-related inequalities in foregone dental care and less widening of these inequalities. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Crisis?: What crisis?: currency vs. banking in the financial crisis of 1931

    OpenAIRE

    Albrecht Ritschl; Samad Salferaz

    2010-01-01

    This paper examines the role of currency and banking in the German financial crisis of 1931 for both Germany and the U.S. We specify a structural dynamic factor model to identify financial and monetary factors separately for each of the two economies. We find that monetary transmission through the Gold Standard played only a minor role in causing and propagating the crisis, while financial distress was important. We also find evidence of crisis propagation from Germany to the U.S. via the ban...

  13. Financial Crisis in Russia: Cuases and Prospects

    Directory of Open Access Journals (Sweden)

    Seungweon Suh

    1998-06-01

    Full Text Available Although we cannot exclude the reason for financial crisis in Russia's foreign exchange is the depreciation of Rupees and a loss for foreign investment caused the currency crisis in Asia, but most people predicted that by the support of the Russian government and the deflation efforts it will soon go back to stable. And other people said that there is no possibility of causing the world economic chaos but also no possibility for this situation to evolve into a situation where old policy replaced by new one and where there is Country moratorium. At the time when the prediction was made, since the Korea-Russia relationship is still weak, this Russian Crisis caused small influence on Korean Economy. But some section like exporting electronic products and food which rely Russia quite a lot, should analyze the situation carefully in order to face the shrinkage of market demand of Russia.

  14. The first occurrence of a CTX-M ESBL-producing Escherichia coli outbreak mediated by mother to neonate transmission in an Irish neonatal intensive care unit.

    LENUS (Irish Health Repository)

    O'Connor, Ciara

    2017-01-05

    Escherichia coli (E. coli) comprise part of the normal vaginal microflora. Transfer from mother to neonate can occur during delivery resulting, sometimes, in neonatal bacterial disease. Here, we aim to report the first outbreak of CTX-M ESBL-producing E. coli with evidence of mother-to-neonate transmission in an Irish neonatal intensive care unit (NICU) followed by patient-to-patient transmission.

  15. Crisis Thought

    OpenAIRE

    Morris, Edwin Kent

    2016-01-01

    Crisis thought is an idea that gives a name to and accounts for some of the problematics of the sign crisis in political, social, cultural, and economic discourse. Specifically, crisis thought is a discursive formation, a concept used loosely here to refer to an assemblage of signs such as anxiety or fear that evoke or invoke similar, but inaccurate connotations as crisis in political and everyday usage. The general question this study grapples with is why political, social, cultural, and eco...

  16. Underemployment among Mothers of Children with Intellectual Disabilities

    Science.gov (United States)

    Chou, Yueh-Ching; Kröger, Teppo; Pu, Cheng-yun

    2018-01-01

    Background: Mothers with lifelong care responsibilities might involuntarily be non-employed or work part-time, both of which are defined as "underemployment." This study aimed to investigate who these underemployed mothers are and what are the factors associated with such employment hardship when having a child with intellectual…

  17. Making meaning of pumping for mothers of infants with congenital diaphragmatic hernia.

    Science.gov (United States)

    Froh, Elizabeth B; Deatrick, Janet A; Curley, Martha A Q; Spatz, Diane L

    2015-01-01

    To describe the process of initiation and maintenance of milk supply and potential transition to direct breastfeeding among mother/infant dyads with infants with congenital diaphragmatic hernia (CDH). A Level-III neonatal intensive care unit. Eleven mother/infant dyads with infants with CDH. Prospective, longitudinal qualitative descriptive design. Semistructured interviews were conducted over the course of the NICU stay. Conventional content analysis was used. Human milk oral care emerged from the interview data as a strong facilitating factor to encouraging mothers to continue pumping during hospitalization. Four main themes emerged regarding the importance and value of human milk oral care for the mothers in relation to pumping and maintenance of milk supply: (a) It motivates me; (b) I'm a part of my baby getting better; (c) We do it together, and (d) We're getting somewhere. The findings of this study reflect the importance and value of human milk oral care as a driving factor to motivate mothers to maintain milk supply during the critical time when the infant with CDH is not able to take in enteral nutrition and throughout the hospital stay. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  18. Nine centuries waiting: The experiences of Iranians surrogacy commissioning mothers

    Science.gov (United States)

    Zandi, Mitra; Vanaki, Zohreh; Shiva, Marziyeh; Mohammadi, Eesa

    2014-01-01

    Background: There are a few studies about commissioning mothers’ understanding from the surrogacy during 9 months of waiting for delivery in Iran and other countries. This study was conducted with an aim to explore and explain the nature of concerns (experiences) of commissioning mothers. Materials and Methods: A qualitative design with a conventional content analysis approach was used to gather and analyze the experiences of commissioning mothers. They were selected from Royan Research Centre and other infertility centers in Iran. After purposive sampling for the selection of the participants, unstructured interviews were held for data collection. Twenty-four unstructured interviews were conducted with 12 commissioning mothers, 2 surrogate mothers, and 2 infertility center social workers who directly and continuously dealt with these mothers. Results: Two main themes emerged from the data analysis: 1. cultural dilemma (consisting of three subthemes: Social taboo, concerns about disclosure to others and the child, concerns about altering maternal and child's identity, and 2. uncertain waiting (consisting of three subthemes: Concerns about health of fetus and surrogate, concerns about an unfamiliar surrogate, and concerns about lack of preparation for maternal role). Conclusions: The study reveals the importance of maternal emotional care in this group and introduces a new arena for nurses’ activity. These findings help the mothers by nurses’ activities in health care clinics and anywhere they deliver nursing care. PMID:24949058

  19. Kangaroo mother method: randomised controlled trial of an alternative method of care for stabilised low-birthweight infants. Maternidad Isidro Ayora Study Team.

    Science.gov (United States)

    Sloan, N L; Camacho, L W; Rojas, E P; Stern, C

    1994-09-17

    Because resources for care of low-birthweight (LBW) infants in developing countries are scarce, the Kangaroo mother method (KMM) was developed. The infant is kept upright in skin-to-skin contact with the mother's breast. Previous studies reported several benefits with the KMM but interpretation of their findings is limited by small size and design weaknesses. We have done a longitudinal, randomised, controlled trial at the Isidro Ayora Maternity Hospital in Quito, Ecuador. Infants with LBW (groups (n = 128 and 147, respectively). During 6 months of follow-up the KMM group had a significantly lower rate than the control group of serious illness (lower-respiratory-tract disorders, apnoea, aspiration, pneumonia, septicaemia, general infections; 7 [5%] vs 27 [18%], p groups in less severe morbidity were not significant. There was no significant difference in growth or in the proportion of women breastfeeding, perhaps because the proportion breastfeeding was high in both groups owing to strong promotion. Mortality was the same in both groups; most deaths occurred during the stabilisation period before randomisation. KMM mothers made more unscheduled clinic visits than control mothers but their infants had fewer re-admissions and so the cost of care was lower with the KMM. Since the eligibility criteria excluded nearly 50% of LBW infants from the study, the KMM is not universally applicable to these infants. The benefits might be greater in populations where breastfeeding is not so common.

  20. The effect of happiness training on self-esteem in the mothers of children with cleft lip and palate in Isfahan 2015.

    Science.gov (United States)

    Hemati, Zeinab; Derakhshande, Fateme; Abbasi, Samira; Kiani, Davood

    2017-01-01

    Birth of a child with cleft lip and palate, as a crisis, can affect family relationships and interactions seriously and hence self-esteem in family members. The present study was conducted to investigate the effect of a happiness training program on self-esteem in the mothers of children with cleft lip and palate. In this quasi-experimental study, 64 mothers of children with cleft lip and palate referring to health-care team in the Isfahan University Medical Sciences were enrolled by convenience random sampling. Then, the program of happiness training was implemented within 10 sessions, and a questionnaire of demographic characteristics and Coopersmith Self-Esteem Inventory was filled out before and 2 months after the last session. The data were analyzed by descriptive and analytical statistics (paired t -test, independent t -test, Chi-square, and Mann-Whitney) in SPSS 20 (SPSS Inc: Chicago). The mean age of the mothers in intervention and control groups was 33.3 ± 6.3 and 33.5 ± 5.8 years, respectively. The mean age of the children in the intervention and control groups was 6.34 ± 3.37 and 5.03 ± 3.36 years. Independent t -test indicated a significant difference in self-esteem mean score after training in the intervention and control groups. Moreover, paired t -test indicated a significant difference in self-esteem mean score between before and after training in the intervention group. In the light of the effect of happiness training on the promotion of self-esteem in children with cleft lip and palate, this program can be used as a care intervention to reduce psychological and mental problems and to enhance adjustment in parents.

  1. First-time mothers' experiences of early labour in Italian maternity care services.

    Science.gov (United States)

    Cappelletti, Giulia; Nespoli, Antonella; Fumagalli, Simona; Borrelli, Sara E

    2016-03-01

    The aim of this study is to explore first-time mothers' experiences of early labour in Italian maternity care services when admitted to hospital or advised to return home after maternity triage assessment. The study was conducted in a second-level maternity hospital in northern Italy with an obstetric unit for both low- and high-risk women. The participants included 15 first-time mothers in good general health with spontaneous labour at term of a low-risk pregnancy who accessed maternity triage during early labour, and were either admitted to hospital or advised to return home. A qualitative interpretive phenomenological study was conducted. A face-to-face recorded semi-structured interview was conducted with each participant 48-72h after birth. Four key themes emerged from the interviews: (a) recognising signs of early labour; (b) coping with pain at home; (c) seeking reassurance from healthcare professionals; and (d) being admitted to hospital versus returning home. Uncertainty about the progression of labour and the need for reassurance were cited by women as the main reasons for hospital visit in early labour. An ambivalent feeling was reported by the participants when admitted to hospital in early labour. In fact, while the women felt reassured in the first instance, some women subsequently felt dissatisfied due to the absence of one-to-one dedicated care during early labour. When advised to return home, a number of women reported feelings of disappointment, anger, fear, discouragement and anxiety about not being admitted to hospital; however, some of these women reported a subsequent feeling of comfort due to being at home and putting in place the suggestions made by the midwives during the maternity triage assessment. The guidance provided by midwives during triage assessment seemed to be the key factor influencing women׳s satisfaction when advised either to return home or to stay at the hospital during early labour. During antenatal classes and clinics

  2. Palestinian mothers' perceptions of child mental health problems and services

    Science.gov (United States)

    THABET, ABDEL AZIZ; EL GAMMAL, HOSSAM; VOSTANIS, PANOS

    2006-01-01

    The aim of this study was to explore Palestinian mothers' perceptions of child mental health problems and their understanding of their causes; to determine Palestinian mothers' awareness of existing services and sources of help and support; to identify professionals in the community whom Palestinian mothers would consult if their child had mental health problems; and to establish their views on ways of increasing awareness of child mental health issues and services. Checklists exploring the above issues were completed by 249 Palestinian mothers living in refugee camps in the Gaza Strip. Palestinian mothers equally perceived emotional, behavioural and psychotic symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, parental psychiatric illness and social adversity. A substantial proportion (42.6%) had knowledge of local child mental health care services. Overall, mothers preferred Western over traditional types of treatment, and were keen to increase mental health awareness within their society. Despite a different cultural tradition, Palestinian mothers appear open to a range of services and interventions for child mental health problems. As in other non-Western societies, child mental health service provision should be integrated with existing primary health care, schools, and community structures. PMID:16946953

  3. Midlife mothers favor `being with' children over work and careers.

    Science.gov (United States)

    Morgan, Patricia Ann; Merrell, Joy A; Rentschler, Dorothy

    2015-01-01

    The majority of American women juggle careers and the demands of mothering. The experiences of midlife mothers on the issues of work and motherhood are important to explore because birth rates for older women continue to rise in the United States and in other countries including the U.K. and Canada. To present a unique viewpoint on work and mothering from the perspectives and experiences of older first-time mothers. A purposive sample of thirteen women aged 45-56 years old participated in two in-depth interviews. Findings emerged in the context of a larger hermeneutic phenomenological study that aimed to understand older first-time mothers' perceptions of health and mothering during the transition to menopause. A paradox emerged in which the realities of motherhood did not meet the women's expectations. They were surprised by the centrality of commitment they felt towards the child and voiced strong ideals about how to do mothering right that included making changes to work schedules to be more available to their children. Health care professionals should be aware of specific issues that exist for older first-time mothers including adjustments to work. This knowledge will inform the support, education and care provided for these women.

  4. Precarious work and care responsibilities in the economic crisis

    Czech Academy of Sciences Publication Activity Database

    Hašková, Hana; Dudová, Radka

    2017-01-01

    Roč. 27, č. 1 (2017), s. 47-63 ISSN 0959-6801 R&D Projects: GA ČR GA15-07898S; GA ČR GA15-13766S Institutional support: RVO:68378025 Keywords : Czech Republic * economic crisis * precarious work Subject RIV: AO - Sociology, Demography OBOR OECD: Sociology Impact factor: 1.159, year: 2016 http://ejd.sagepub.com/content/early/2016/10/13/0959680116672279.full.pdf+html

  5. Police Mental Health Partnership project: Police Ambulance Crisis Emergency Response (PACER) model development.

    Science.gov (United States)

    Huppert, David; Griffiths, Matthew

    2015-10-01

    To review internationally recognized models of police interactions with people experiencing mental health crises that are sometimes complex and associated with adverse experience for the person in crisis, their family and emergency service personnel. To develop, implement and review a partnership model trial between mental health and emergency services that offers alternative response pathways with improved outcomes in care. Three unique models of police and mental health partnership in the USA were reviewed and used to develop the PACER (Police Ambulance Crisis Emergency Response) model. A three month trial of the model was implemented and evaluated. Significant improvements in response times, the interactions with and the outcomes for people in crisis were some of the benefits shown when compared with usual services. The pilot showed that a partnership involving mental health and police services in Melbourne, Australia could be replicated based on international models. Initial data supported improvements compared with usual care. Further data collection regarding usual care and this new model is required to confirm observed benefits. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  6. Taking Care, Bringing Life: A Post-structuralist Feminist Analysis of Maternal Discourses of Mothers and Dais in India.

    Science.gov (United States)

    Agarwal, Vinita

    2018-04-01

    My post-structuralist feminist reading of the antenatal and birthing practices of women (N = 25) living in a basti in India makes visible how the meanings of maternal experiences constituted as our ways open discursive spaces for the mothers and dais as procreators to: challenge (i.e., question the authority of), co-opt (i.e., conditionally adopt), and judge (i.e., employ sanctioned criteria to regulate) competing knowledge production forms. In critiquing maternal knowledge as feminist discourse, the women's strategies contribute theoretically to an integrative construction of care by reclaiming displaced knowledge discourses and diversity in meaning production. Pragmatically, consciousness-raising collectives comprising the mothers and dais can cocreate narratives of our ways of maternal experiences articulated in public discourse to sustain equitability of knowledge traditions in migrant urban Third World contexts.

  7. ANXIETY AND ATTACHMENT TO THE MOTHER IN PRESCHOOLERS RECEIVING PSYCHIATRIC CARE: THE FATHER-CHILD ACTIVATION RELATIONSHIP AS A PROTECTIVE FACTOR.

    Science.gov (United States)

    Gaumon, Sébastien; Paquette, Daniel; Cyr, Chantal; Émond-Nakamura, Mutsuko; St-André, Martin

    2016-07-01

    This 49-family study is the first to explore the father-child relationship in a clinical population of preschoolers (at a tertiary care child psychiatry clinic) and to examine its relation to child anxiety and attachment to the mother. A moderation model of the father-child activation relationship on the relation between attachment to the mother and child anxiety was tested and discussed. Analyses confirmed the expected independence between mother-child attachment and father-child activation as well as the association between mother-child attachment and anxiety. The highest levels of anxiety were found in insecure children, and more specifically, in insecure-ambivalent children and insecure disorganized-controlling children of the caregiving subtype. Hypotheses regarding the relation between anxiety and activation were only partially confirmed. Finally, the activation relationship with the father was shown to have a moderating effect on the relation between attachment to the mother and child anxiety; activation by the father may be considered either a protective or a risk factor. Results for this clinical population of young children are discussed in the light of attachment theory and activation relationship theory. The study's findings have the potential to contribute to the development of preventative, diagnostic, and intervention programs that take both parental figures into account. © 2016 Michigan Association for Infant Mental Health.

  8. Was the 2007 crisis really a global banking crisis?

    NARCIS (Netherlands)

    Shehzad, Choudhry Tanveer; De Haan, Jakob

    We argue that the 2007 crisis was not a global banking crisis. Stock prices of banks in emerging countries faced a temporary shock but quickly recovered, while stock prices of banks located in industrial countries remained much lower than before the 2007 crisis. Our results also suggest that stock

  9. Mortality in hyperglycemic crisis: a high association with infections and cerebrovascular disease.

    Science.gov (United States)

    Ekpebegh, C; Longo-Mbenza, B

    2013-06-01

    Aim of the present study was to determine syndrome specific mortality rates and the precipitating factors associated with deaths following admission for hyperglycemic crisis to a high care unit. Retrospective review of medical records for hyperglycemic crisis at Nelson Mandela Academic Hospital, Mthatha, Eastern Cape Province of South Africa from February 1 2010 to January 31 2011. All admissions were initially into the high care unit. The overall mortality rates (per admissions) was 13.9% (N.=15/108) with syndrome specific mortality rates (per admissions) of 11.9% (N.=8/67), 0% (N.=0/8) and 21.2% (N.=7/33) respectively for diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS) and hyperglycemia with dehydration (HD). The precipitating factors that were mainly associated with mortality were infections and cerebrovascular disease (CVD). The patients with CVD who died were all unconscious. There were no deaths where non-compliance with hypoglycaemic agents (14.8%, N.=16/108) was the precipitating factor. The overall mortality rates (per admissions) following high care unit admissions for hyperglycemic crisis was 13.9% with infections and CVD as the precipitating factors most associated with deaths.

  10. [Economic crisis and mental health. SESPAS report 2014].

    Science.gov (United States)

    Gili, Margalida; García Campayo, Javier; Roca, Miquel

    2014-06-01

    Studies published before the financial crisis of 2008 suggest that economic difficulties contribute to poorer mental health. The IMPACT study conducted in primary health care centers in Spain found a significant increase in common mental disorders. Between 2006 and 2010, mood disorders increased by 19%, anxiety disorders by 8% and alcohol abuse disorders by 5%. There were also gender differences, with increased alcohol dependence in women during the crisis period. The most important risk factor for this increase was unemployment. In parallel, antidepressant consumption has increased in recent years, although there has not been a significant inrease in the number of suicides. Finally, the study offers some proposals to reduce the impact of the crisis on mental health: increased community services, employment activation measures, and active policies to reduce alcohol consumption and prevent suicidal behavior, particularly among young people. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. School Crisis Management: A Model of Dynamic Responsiveness to Crisis Life Cycle

    Science.gov (United States)

    Liou, Yi-Hwa

    2015-01-01

    Purpose: This study aims to analyze a school's crisis management and explore emerging aspects of its response to a school crisis. Traditional linear modes of analysis often fail to address complex crisis situations. The present study applied a dynamic crisis life cycle model that draws on chaos and complexity theory to a crisis management case,…

  12. The potential role of mother-in-law in prevention of mother-to-child transmission of HIV: a mixed methods study from the Kilimanjaro region, northern Tanzania

    Directory of Open Access Journals (Sweden)

    Leshabari Sebalda

    2011-07-01

    Full Text Available Abstract Background In the Kilimanjaro region the mother-in-law has traditionally had an important role in matters related to reproduction and childcare. The aim of this study was to explore the role of the mothers-in-law in prevention of mother-to-child transmission (PMTCT service utilization and adherence to infant feeding guidelines. Methods The study was conducted during 2007-2008 in rural and urban areas of Moshi district in the Kilimanjaro region of Tanzania. Mixed methods were used and included focus group discussions with mothers-in-law, mothers and fathers; in-depth interviews with mothers-in-law, mothers, fathers and HIV-infected mothers, and a survey of 446 mothers bringing their four-week-old infants for immunisation at five reproductive and child health clinics. Results The study demonstrated that the mother-in-law saw herself as responsible for family health issues in general and child care in particular. However she received limited trust, and couples, in particular couples living in urban areas, tended to exclude her from decisions related to childbearing and infant feeding. Mothers-in-law expected their daughters-in-law to breastfeed in a customary manner and were generally negative towards the infant feeding methods recommended for HIV-infected mothers; exclusive replacement feeding and exclusive breastfeeding. Conclusions Decreasing influence of the mother-in-law and increasing prominence of the conjugal couples in issues related to reproduction and child care, reinforce the importance of continued efforts to include male partners in the PMTCT programme. The potential for involving mothers-in-law in the infant feeding component, where she still has influence in some areas, should be further explored.

  13. Changes in Mothers' Psychosocial Perceptions of Technology-dependent Children and Adolescents at Home in Japan: Acknowledgement of Children's Autonomy.

    Science.gov (United States)

    Nishigaki, Kaori; Kanamori, Yutaka; Ikeda, Mari; Sugiyama, Masahiko; Minowa, Hideko; Kamibeppu, Kiyoko

    2016-06-01

    This research was conducted to reveal Japanese mothers' changing perceptions towards their technology-dependent children in the home care setting. Fourteen Japanese mothers participated in semi-structured interviews, which were analyzed using a grounded theory approach. "Degree of preoccupation with the child" emerged as the category representing the mothers' perceptions towards their child. Three categories emerged that represented the progression of maternal perceptions over time: "accepting the child's conditions", "mastering the management of care in various conditions", and "considering social participation for the child". First, mothers gradually accepted the conditions of their child after his/her disease and disability were known. Second, others managed technology-required care and concurrently considered the social participation of their child through daily care at home. Third, the level of preoccupation with the child was affected by the mothers' management of care and their attitude towards the social participation of their child in home care. In this study, as is widely alleged in historical recognition of Japan, mothers provided daily care almost without help from other family members. Additionally, they thought it natural and good for their children. Above all, especially in Japan, professional support for mothers are necessary so that they can take breaks from care. Copyright © 2016. Published by Elsevier B.V.

  14. Newborn care practices and home-based postnatal newborn care programme – Mewat, Haryana, India, 2013

    Directory of Open Access Journals (Sweden)

    Latika Nath Sinha

    2014-09-01

    Full Text Available Background: In India, the Home Based Postnatal Newborn Care programme by Accredited Social Health Activists (ASHAs under the National Rural Health Mission was initiated in 2011 to reduce neonatal mortality rates (NMRs. ASHAs get cash incentives for six postnatal home visits for newborn care. We studied newborn care practices among mothers in Mewat, Haryana, having a high NMR and determined risk factors for unsafe practices and described the knowledge and skills of ASHAs during home visits. Methods: A cross-sectional survey was conducted among mothers who had delivered a child during the previous seven months using cluster sampling. We interviewed mothers and ASHAs in the selected subcentres using semi–structured questionnaires on the six safe newborn care practices, namely safe breastfeeding, keeping cord and eyes clean, wrapping baby, kangaroo care, delayed bathing and hand washing. Results: We interviewed 320 mothers, 61 ASHAs and observed 19 home visits. Overall, 60% of mothers adopted less than three safe practices. Wrapping newborns (96% and delayed bathing (64% were better adopted than cord care (49%, safe breastfeeding (48%, hand washing (30%, kangaroo care (20% and eye care (9%. Cultural beliefs and traditional birth attendants influenced the mother’s practices. The lack of supervision by auxiliary nurse midwives (ANM, delayed referral and transportation were the other challenges. Conclusion: Knowledge–practice gaps existed among mothers counselled by ASHAs. Poor utilization of reproductive and child health services decreased opportunities for ASHA–mother dialogue on safe practices. Recommendations included training ANMs, training TBAs as ASHAs, innovative communication strategies for ASHAs and improved referral system.

  15. Causes and consequences of the Spanish economic crisis: Why the recovery is taken so long?

    Directory of Open Access Journals (Sweden)

    Carballo-Cruz Francisco

    2011-01-01

    Full Text Available Spain is currently facing its worst crisis in the last fifty years. The crisis began as an extension of the international financial crisis, but the internal imbalances accumulated in the pre-crisis period aggravated the situation. At present their incomplete adjustment is making difficult the economic recovery. This paper describes the evolution of the economic crisis in Spain. The real estate sector and the banking sector are analyzed in detail, as they played a key role in the detonation and the deepening of the crisis. The results of the main reforms carried out so far are also carefully examined. It also discusses the main factors that have delayed the economic recovery up to now (unemployment and indebtedness, and present some alternatives to define an exit strategy.

  16. Prevalence and Factors Associated with Depressive Symptoms in Mothers with Infants or Toddlers

    Directory of Open Access Journals (Sweden)

    Hua-Pin Chang

    2014-12-01

    Conclusion: Depressive symptoms were common among mothers of young children. Family function and neurotic personality were highly correlated with depressive symptoms in mothers caring for young children. Pediatric health care providers are suggested to screen for maternal depressive symptoms and provide family-oriented support in Taiwan.

  17. Children and adolescents living with atopic eczema: an interpretive phenomenological study with Chinese mothers.

    Science.gov (United States)

    Cheung, Winnie K H; Lee, Regina L T

    2012-10-01

    This article is a report on a phenomenological study of Chinese mothers' experiences of caring for their children who were living with atopic eczema. A mother's attitude and personality may have a direct influence on her child's adherence to treatment for atopic eczema. Thus, good communication between healthcare professionals and the mother is essential. Treatment and care should also be culturally appropriate. Using an interpretive phenomenological method, 14 interviews were conducted in Hong Kong, China from September 2007 to August 2008, with nine mothers caring for their children who were living with atopic eczema. Crist and Tanner's circular process of hermeneutic interpretive phenomenology was chosen to guide the data analysis. Mothers' coping patterns involved persistently dealing with enduring demands and seeking alternative therapies that were aimed at curing the disease. Four themes finally emerged from the data: (1) dealing with extra mothering, (2) giving up their life, (3) becoming an expert and (4) living with blame and worry. Mothers' coping patterns involved persistently finding ways to relieve their children's suffering with the aim of curing the disease and dealing with their own emotions related to the frustration resulting from giving up their life and living with blame and worry. The study findings provide nurses with an empathic insight into mothers' feelings and the enduring demands of caring for children with atopic eczema, and help nurses to develop culturally sensitive interventions, reinforce positive coping strategies, increase family function and improve health outcomes. © 2011 Blackwell Publishing Ltd.

  18. Kangaroo mother care for clinically unstable neonates weighing ≤2000 g: Is it feasible at a hospital in Uganda?

    Science.gov (United States)

    Morgan, Melissa C; Nambuya, Harriet; Waiswa, Peter; Tann, Cally; Elbourne, Diana; Seeley, Janet; Allen, Elizabeth; Lawn, Joy E

    2018-06-01

    Kangaroo mother care (KMC) for stable neonates ≤2000 g (g) is associated with decreased mortality, sepsis, hypothermia, and length of stay compared to conventional care. The World Health Organization states that KMC "should be initiated… as soon as newborns are clinically stable " [12]. However, the majority of deaths occur in unstable neonates. We aimed to determine the proportion of admitted neonates meeting proposed instability criteria, assess the feasibility of providing KMC to unstable neonates, and evaluate the acceptability of this intervention to parents and providers at Jinja Regional Referral Hospital in Uganda. This was a mixed-methods study. We recorded data including birthweight, chronological age, and treatments administered from medical charts, and calculated the percentage of clinically unstable neonates, defined as the need for ≥2 medical therapies in the first 48 hours of admission. We enrolled a sample of neonates meeting pre-defined instability criteria. Mothers were counselled to provide KMC as close to continuously as possible. We calculated the median duration of KMC per episode and per day. To explore acceptability, we conducted semi-structured interviews with parents and newborn unit care providers, and analysed data using the thematic content approach. We included 254 neonates in the audit, 10 neonates in the feasibility sub-study, and 20 participants in the acceptability sub-study. Instability criteria were easily implementable, identifying 89% of neonates as unstable in the audit. The median duration of individual KMC episodes ranged from 115 to 134 minutes. The median daily duration ranged from 4.5 to 9.7 hours. Seventy-five percent of interviewees felt KMC could be used in neonates concurrently receiving other medical therapies. Barriers included lack of resources (beds/space, monitoring devices), privacy issues, inadequate education, and difficulties motivating mothers to devote time to KMC. Recommendations included staff

  19. Mother-Infant Interaction: a Process of Discoveries

    Directory of Open Access Journals (Sweden)

    Dorian Mônica Arpini

    2016-08-01

    Full Text Available Considering the importance of the first experiences to the psychological constitution and that such constitution is based on parental relationships, this study aimed to comprehend the aspects that indicate health and well-being in the mother-baby relationship, focusing on the moments of breastfeeding, cry, communication and interaction of the dyad. The study was grounded on observation and an interview with the mothers. Results emerged from content analysis and highlight the presence of indicators of the Child Development Risks Index (IRDIs in the relationship of the dyad, evidencing mothers hold knowledge about their babies. Final considerations emphasize the importance of the mother-baby relationship and suggest the inclusion of Clinical Indicators of Risk regarding Child Development in services of primary health care.

  20. Associations between perceived crisis mode work climate and poor information exchange within hospitals.

    Science.gov (United States)

    Patterson, Mark E; Bogart, Miller S; Starr, Kathleen R

    2015-03-01

    Because hospital units operating in crisis mode could create unsafe transitions of care due to miscommunication, our objective was to estimate associations between perceived crisis mode work climate and patient information exchange problems within hospitals. Self-reported data from 247,140 hospital staff members across 884 hospitals were obtained from the 2010 Hospital Survey on Patient Safety Culture. Presence of a crisis mode work climate was defined as respondents agreeing that the hospital unit in which they work tries to do too much too quickly. Presence of patient information exchange problems was defined as respondents agreeing that problems often occur in exchanging patient information across hospital units. Multivariable ordinal regressions estimated the likelihood of perceived problems in exchanging patient information across hospital units, controlling for perceived levels of crisis mode work climate, skill levels, work climate, and hospital infrastructure. Compared to those disagreeing, hospital staff members agreeing that the hospital unit in which they work tries to do too much too quickly were 1.6 times more likely to perceive problems in exchanging patient information across hospital units (odds ratio: 1.6, 95% confidence interval: 1.58-1.65). Hospital staff members perceiving crisis mode work climates within their hospital unit are more likely to perceive problems in exchanging patient information across units, underscoring the need to improve communication during transitions of care. © 2014 Society of Hospital Medicine.

  1. Adrenal Crisis: Still a Deadly Event in the 21st Century.

    Science.gov (United States)

    Puar, Troy H K; Stikkelbroeck, Nike M M L; Smans, Lisanne C C J; Zelissen, Pierre M J; Hermus, Ad R M M

    2016-03-01

    Adrenal crisis is a life-threatening medical emergency, associated with a high mortality unless it is appropriately recognized and early treatment is rendered. Despite it being a treatable condition for almost 70 years, failure of adequate preventive measures or delayed treatment has often led to unnecessary deaths. Gastrointestinal illness is the most common precipitant for an adrenal crisis. Although most patients are educated about "sick day rules," patients, and physicians too, are often reluctant to increase their glucocorticoid doses or switch to parenteral injections, and thereby fail to avert the rapid deterioration of the patients' condition. Therefore, more can be done to prevent an adrenal crisis, as well as to ensure that adequate acute medical care is instituted after a crisis has occurred. There is generally a paucity of studies on adrenal crisis. Hence, we will review the current literature, while also focusing on the incidence, presentation, treatment, prevention strategies, and latest recommendations in terms of steroid dosing in stress situations. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Changes in Mothers' Psychosocial Perceptions of Technology-dependent Children and Adolescents at Home in Japan: Acknowledgement of Children's Autonomy

    Directory of Open Access Journals (Sweden)

    Kaori Nishigaki, RN, PHN, PhD

    2016-06-01

    Conclusions: First, mothers gradually accepted the conditions of their child after his/her disease and disability were known. Second, others managed technology-required care and concurrently considered the social participation of their child through daily care at home. Third, the level of preoccupation with the child was affected by the mothers' management of care and their attitude towards the social participation of their child in home care. In this study, as is widely alleged in historical recognition of Japan, mothers provided daily care almost without help from other family members. Additionally, they thought it natural and good for their children. Above all, especially in Japan, professional support for mothers are necessary so that they can take breaks from care.

  3. Activation of the maternal caregiving system by childhood fever--a qualitative study of the experiences made by mothers with a German or a Turkish background in the care of their children.

    Science.gov (United States)

    Langer, Thorsten; Pfeifer, Miriam; Soenmez, Aynur; Kalitzkus, Vera; Wilm, Stefan; Schnepp, Wilfried

    2013-03-18

    Childhood fever represents a frequent cause to consult a primary care physician. "Fever phobia" describes a fearful and irrational view of fever shared by many parents with different cultural backgrounds. The study aims to explain the experiences of mothers of children having a fever and to analyze the role of the mothers' cultural background with regard to their experiences by comparing the accounts of mothers with a German with those from a Turkish background. Disease and context specific knowledge about the influence of culture can be important for effective counselling. We applied a qualitative approach using in-depth interviews with 11 mothers with a Turkish and 9 with a German background living in Germany. The interviews were conducted at the participants' homes from May to October 2008. Data was audio-recorded and transcribed verbatim. Grounded Theory was used as a framing methodology including open, axial and selective coding. Analysis was performed in a group with members of different professional and cultural backgrounds. Mothers experienced their child's fever not merely as elevated temperature but as a potentially dangerous event. A deeply rooted urge to protect the child from harm was central to all participants' experience. The caregiving system model offers a good theoretical foundation to explain the findings as it incorporates the unique relational quality of care giving mothers to their children. The cultural background represents an important context variable influencing the explanatory models and strategies of dealing with fever. The identified culturally influenced concepts sometimes match and sometimes conflict with medical knowledge. By applying the caregiving system model which is a part of attachment theory (Bowlby) maternal actions can be understood as an understandable attempt to protect the child from harm. The mothers' decisions what to do when a child has a fever can be culturally influenced. This may lead either to a frequent use of

  4. Crisis of Meaning Predicts Suicidality in Youth Independently of Depression.

    Science.gov (United States)

    Schnell, Tatjana; Gerstner, Rebekka; Krampe, Henning

    2018-02-23

    At times, the question for meaning comes to nothing and a crisis of meaning ensues. This state is very painful, but difficult to account. Both those who suffer from it and care professionals find themselves at a loss for words. This study introduces an operationalization of a crisis of meaning. It aims to distinguish the concept from depression, and to investigate whether a crisis of meaning can explain suicidality beyond the known protective and risk factors self-esteem, family functioning, life-event load, and depression. Final-year school pupils in Ecuador (N = 300) completed questionnaires assessing the above variables. Data were analyzed using chi-square, hierarchic multiple regression, serial mediation, and moderator analyses. Crisis of meaning was distinguished from depression. It explained a significant amount of variance in suicidality beyond the mentioned protective and risk factors. For males, crisis of meaning was the only significant risk factor, and the strongest predictor overall. The acute risk factors depression and crisis of meaning mediated the effects of the baseline factors self-esteem, family functioning, and life-event load on suicidality. The study was cross-sectional; assessed factors predicted variance in suicidal thoughts, plans, and past suicide attempts, while their relevance cannot be generalized to actual future suicide attempts. A crisis of meaning is an important factor to take into account in further research on the prevention and treatment of people at risk of suicide.

  5. When breastfeeding is unsuccessful--mothers' experiences after giving up breastfeeding

    DEFF Research Database (Denmark)

    Larsen, Jette Schilling; Kronborg, Hanne

    2013-01-01

    by meaning condensation. The mothers experienced that giving up breastfeeding was a crucial but necessary decision for the child’s health and well-being. They tried to “be on the side of the angels” by caring for and bonding with the child. The mothers were divided between expressing milk or formula feeding...... that mothers who have to give up breastfeeding need special attention and support....

  6. Unified communication to reach vulnerable mothers.

    Science.gov (United States)

    Tezcan, B; Von Rege, I; Henkson, H; Oteng-Ntim, E

    2011-01-01

    The feasibility of using a mobile text to reach vulnerable patient groups was assessed in this study. A total of 121 pregnant or postnatal women were randomly asked to complete a questionnaire. The questionnaire was given to them in the antenatal clinic, postnatal ward, antenatal ward or in the day assessment unit at St Thomas' Hospital, London. The forms were collected and analysed using an Excel database. The results of this survey show that mobile technology is readily available for 97% of the obstetric population. In mothers from vulnerable groups and in mothers from deprived areas, 61% possessed 3rd generation mobile technology. The majority of mothers surveyed wanted their care supplemented by the use of their mobile phones.

  7. Parental management of adrenal crisis in children with congenital adrenal hyperplasia.

    Science.gov (United States)

    Fleming, Louise; Knafl, Kathleen; Knafl, George; Van Riper, Marcia

    2017-10-01

    Congenital adrenal hyperplasia (CAH) requires parents to inject their child with hydrocortisone intramuscularly during times of illness and adrenal crisis. The purpose of this study was to describe circumstances surrounding adrenal crisis events in children with CAH; to explore parents' perceptions of the consequences of having a child with a life-threatening condition; and to examine a relationship between parents' perceived management ability and the impact CAH has on the family. In Phase 1 of this mixed-methods, cross-sectional study, 77 parents were asked to complete questionnaires comprising measures of family life in the context of childhood illness. Descriptive statistics were computed with four separate analyses using linear mixed models allowing for correlation between responses from parents of the same family and for the variance to be different for fathers and mothers. The following relationships were examined: (1) parental management ability and type of provider instruction on how to manage adrenal crises; (2) parental management ability and child age; (3) the perceived impact of the condition on the family and management ability; and (4) the age of the child and number of adrenal crisis events. In Phase 2, 16 semi-structured interviews were conducted to elicit detailed descriptions of parents' experiences in managing crises. There was a significant, positive relationship between detailed provider instruction to parents on adrenal crisis management and perceived management ability (p = .02), additionally the stronger the perceived management ability, the less impact CAH had on the family (p crisis events and less perceived ability to manage the condition when compared with parents of older children (p = .009). The threat of an adrenal crisis event is a pervasive concern for parents, especially when they are not being properly prepared by providers. Provider support is needed for these parents throughout childhood, but especially in the first 5 years of

  8. Chinese Crisis Management

    National Research Council Canada - National Science Library

    Gudgel, Andy

    2004-01-01

    .... China's crisis management strategy is geared towards obtaining the maximum political advantage for China, as opposed to resolving the crisis. China tries to define the crisis on its terms in order to shape the resolution favorably.

  9. Stress in Mothers of Hearing Impaired Children Compared to Mothers of Normal and Other Disabled Children

    Directory of Open Access Journals (Sweden)

    Mahnaz Aliakbari Dehkordi

    2011-06-01

    Full Text Available Background and Aim: Stress is associated with life satisfaction and also development of some physical diseases. Birth of a disabled child with mental or physical disability (especially deaf or blind children, impose an enormous load of stress on their parents especially the mothers. This study compared stress levels of mothers with hearing impaired children and mothers of normal children or with other disabilities.Methods: In this study, cluster random sampling was performed in Karaj city. 120 mothers in four groups of having a child with mental retardation, low vision, hearing impairment and with normal children were included. Family inventory of life events (FILE of Mc Cubbin et al. was used to determine stress level in four groups of mothers.Results: The results of this research indicated a significant difference (p<0.05 between stress levels of mothers with hearing impaired children and mothers of other disabled and normal children in subscales of intra-family stress, finance and business strains, stress of job transitions, stress of illness and family care and family members "in and out''. There was no difference between compared groups in other subscales.Conclusion: Since deafness is a hidden inability, the child with hearing impairment has a set of social and educational problems causing great stress for parents, especially to mother. In order to decrease mother’s stress, it is suggested to provide more family consultation, adequate social support and to run educational classes for parents to practice stress coping strategies.

  10. Non-verbal mother-child communication in conditions of maternal HIV in an experimental environment.

    Science.gov (United States)

    de Sousa Paiva, Simone; Galvão, Marli Teresinha Gimeniz; Pagliuca, Lorita Marlena Freitag; de Almeida, Paulo César

    2010-01-01

    Non-verbal communication is predominant in the mother-child relation. This study aimed to analyze non-verbal mother-child communication in conditions of maternal HIV. In an experimental environment, five HIV-positive mothers were evaluated during care delivery to their babies of up to six months old. Recordings of the care were analyzed by experts, observing aspects of non-verbal communication, such as: paralanguage, kinesics, distance, visual contact, tone of voice, maternal and infant tactile behavior. In total, 344 scenes were obtained. After statistical analysis, these permitted inferring that mothers use non-verbal communication to demonstrate their close attachment to their children and to perceive possible abnormalities. It is suggested that the mothers infection can be a determining factor for the formation of mothers strong attachment to their children after birth.

  11. Knowledge, attitudes and practices of mothers and knowledge of ...

    African Journals Online (AJOL)

    Objective: To determine the knowledge, attitudes and practices (KAP) of mothers and the knowledge of health workers regarding care of the newborn umbilical cord. Design: Cross-sectional survey. Subjects: Mothers with infants less than three months of age attending well child clinics and health workers (HW) in the clinics, ...

  12. Mothers' Strategies in Handling the Prematurely Born Infant: a Qualitative Study

    Directory of Open Access Journals (Sweden)

    Afsaneh Arzani

    2015-03-01

    Full Text Available Introduction: Family, especially mother, is faced with numerous challenges by experiencing a premature birth. Since knowing about mother‟s efforts regarding prematurely born infant helps us in our comprehensive understanding of the impact of this incident on the family system and its performance. The present study was carried out to explore the mothers' strategies regarding prematurely born infant. Methods: In a conventional qualitative content analysis, data was collected through purposive sampling by semi-structured deep interviews with 18 mothers who had prematurely born infant during 2012-2013 in the teaching hospitals of the north and northwest of Iran. All the interviews were recorded, typed, and finally analyzed. Results: Data analysis resulted in the extraction of categories of "asking for help, elevating capacity and reducing personal responsibilities and commitments". These categories were revealed in mothers respectively by the different sub-categories of "religious appeal and relying on beliefs, seeking information from the treatment and caring team, participating in infant‟s care, companionship and support of family and friends”, “focusing on positive thinking and imagination, patience and strength " and "ignoring some routine affairs and reducing role-related activities and duties". Conclusion: Considering the uniqueness of the mother's role in responding to the needs of infants, healthcare system should consider mothers as real target in the intervention strategies in order to promote health and quality of life, so maybe this way, the burden of care and management of critical situations caused by a premature birth on the mother can be reduced.

  13. The Ethics of the Financial Crisis and Financial Reform

    NARCIS (Netherlands)

    I.P. van Staveren (Irene)

    2012-01-01

    textabstractThe paper analyses the financial crisis and financial reform from two alternative ethical perspectives as compared to the mainstream one in economics, utilitarianism. It contrasts deontology with the ethics of care and argues that the rule-based deontological approach is not able to

  14. From oil crisis to climate crisis

    International Nuclear Information System (INIS)

    Langseth, Bjarne

    2000-01-01

    The oil crisis in the 1970s led to the shift from oil to hydro- and nuclear power. An almost similar shift might soon come as a ''climate crisis''. A climate crisis may imply a renaissance for hydropower and nuclear power and natural gas will be used on a large scale. In Europe, natural gas is currently considered environmentally friendly. Although there is at present growing opposition to nuclear power in Sweden and Germany, this attitude may change as the result of increased focus on the costs of the alternatives. A forced phase-out of nuclear power in Europe simultaneously with a climate crisis with reduced energy production from fossil fuels is likely to entail significantly increased prices of electricity. In Norway, 98% of the country's electric power production is based on hydro power, which means that much more heating can be based on electricity than in countries in which electricity is produced by combustion of fossil fuels. Much research is in progress to find technologies that will make it possible to shift from fossil fuel energy to energy from renewable sources like solar, water, wind, biomass and geothermal energy

  15. Does the age of acute care physicians impact their (1) crisis management performance and (2) learning after simulation-based education? A protocol for a multicentre prospective cohort study in Toronto and Ottawa, Canada.

    Science.gov (United States)

    Alam, Fahad; LeBlanc, Vicki R; Baxter, Alan; Tarshis, Jordan; Piquette, Dominique; Gu, Yuqi; Filipkowska, Caroline; Krywenky, Ashley; Kester-Greene, Nicole; Cardinal, Pierre; Au, Shelly; Lam, Sandy; Boet, Sylvain; Clinical Trials Group, Perioperative Anesthesia

    2018-04-21

    The proportion of older acute care physicians (ACPs) has been steadily increasing. Ageing is associated with physiological changes and prospective research investigating how such age-related physiological changes affect clinical performance, including crisis resource management (CRM) skills, is lacking. There is a gap in the literature on whether physician's age influences baseline CRM performance and also learning from simulation. We aim to investigate whether ageing is associated with baseline CRM skills of ACPs (emergency, critical care and anaesthesia) using simulated crisis scenarios and to assess whether ageing influences learning from simulation-based education. This is a prospective cohort multicentre study recruiting ACPs from the Universities of Toronto and Ottawa, Canada. Each participant will manage an advanced cardiovascular life support crisis-simulated scenario (pretest) and then be debriefed on their CRM skills. They will then manage another simulated crisis scenario (immediate post-test). Three months after, participants will return to manage a third simulated crisis scenario (retention post-test). The relationship between biological age and chronological age will be assessed by measuring the participants CRM skills and their ability to learn from high-fidelity simulation. This protocol was approved by Sunnybrook Health Sciences Centre Research Ethics Board (REB Number 140-2015) and the Ottawa Health Science Network Research Ethics Board (#20150173-01H). The results will be disseminated in a peer-reviewed journal and at scientific meetings. NCT02683447; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Intensive home treatment for patients in acute psychiatric crisis situations: a multicentre randomized controlled trial.

    Science.gov (United States)

    Cornelis, Jurgen; Barakat, Ansam; Dekker, Jack; Schut, Tessy; Berk, Sandra; Nusselder, Hans; Ruhl, Nikander; Zoeteman, Jeroen; Van, Rien; Beekman, Aartjan; Blankers, Matthijs

    2018-02-27

    Hospitalization is a common method to intensify care for patients experiencing a psychiatric crisis. A short-term, specialised, out-patient crisis intervention by a Crisis Resolution Team (CRT) in the Netherlands, called Intensive Home Treatment (IHT), is a viable intervention which may help reduce hospital admission days. However, research on the (cost-)effectiveness of alternatives to hospitalisation such as IHT are scarce. In the study presented in this protocol, IHT will be compared to care-as-usual (CAU) in a randomized controlled trial (RCT). CAU comprises low-intensity outpatient care and hospitalisation if necessary. In this RCT it is hypothesized that IHT will reduce inpatient days by 33% compared to CAU while safety and clinical outcomes will be non-inferior. Secondary hypotheses are that treatment satisfaction of patients and their relatives are expected to be higher in the IHT condition compared to CAU. A 2-centre, 2-arm Zelen double consent RCT will be employed. Participants will be recruited in the Amsterdam area, the Netherlands. Clinical assessments will be carried out at baseline and at 6, 26 and 52 weeks post treatment allocation. The primary outcome measure is the number of admission days. Secondary outcomes include psychological well-being, safety and patients' and their relatives' treatment satisfaction. Alongside this RCT an economic evaluation will be carried out to assess the cost-effectiveness and cost-utility of IHT compared to CAU. RCTs on the effectiveness of crisis treatment in psychiatry are scarce and including patients in studies performed in acute psychiatric crisis care is a challenge due to the ethical and practical hurdles. The Zelen design may offer a feasible opportunity to carry out such an RCT. If our study finds that IHT is a safe and cost-effective alternative for CAU it may help support a further decrease of in-patient bed days and may foster the widespread implementation of IHT by mental health care organisations

  17. Managing crisis

    OpenAIRE

    Bakacsi, Gyula

    2010-01-01

    The traditional approach to crisis management suggest autocratic leadership, that has risks anyway (leader is the bottle-neck of problem solving, single-loop learning, crisis management is a matter of efficiency). However, managing nowadays crisis is rather effectiveness issue, and requires double-loop learning (second-order change) and leadership role in the sense of Kotter’s theory. Paper discusses the top-management’s leadership responsibilities, and their special tasks in the problem solv...

  18. Fear of childbirth: mothers' experiences of team-midwifery care - a follow-up study.

    Science.gov (United States)

    Lyberg, Anne; Severinsson, Elisabeth

    2010-05-01

    The aim of this study was to illuminate mothers' fear of childbirth and their experiences of the team-midwifery care model during pregnancy, childbirth and the postnatal period. Maternal anxiety and fear of childbirth lead to emotional suffering and affected women's well-being. A previous negative experience of childbirth may result in postnatal depression or avoidance of future pregnancies. This hermeneutic study comprised interviews with 13 women, which were audio-taped and transcribed verbatim, after which interpretative content analysis was performed. Ethical approval was granted. The findings revealed one main theme: The woman's right to ownership of the pregnancy, childbirth and postnatal care as a means of maintaining dignity and three themes; Being aware of barriers and reasons for fear; Being prepared for childbirth and Being confirmed and treated with dignity by the midwife. Each theme contained several sub-themes. The findings contribute insights into how midwives can be educated to reduce fear of childbirth and promote positive birth experiences, despite the existence of negative memories of previous births. In order to achieve continuity and a trusting relationship it is necessary to organise leadership and to adopt models that are flexible and support women's health.

  19. Deployment of military mothers: supportive and nonsupportive military programs, processes, and policies.

    Science.gov (United States)

    Goodman, Petra; Turner, Annette; Agazio, Janice; Throop, Meryia; Padden, Diane; Greiner, Shawna; Hillier, Shannon L

    2013-07-01

    Military mothers and their children cope with unique issues when mothers are deployed. In this article, we present mothers' perspectives on how military resources affected them, their children, and their caregivers during deployment. Mothers described beneficial features of military programs such as family readiness groups and behavioral health care, processes such as unit support, and policies on length and timing of deployments. Aspects that were not supportive included inflexibility in family care plans, using personal leave time and funds for transporting children, denial of release to resolve caretaker issues, and limited time for reintegration. We offer recommendations for enhanced support to these families that the military could provide. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  20. [Burden of mothers and fathers of persons with schizophrenia].

    Science.gov (United States)

    Friedrich, Fabian; Gross, Rainer; Wrobel, Margit; Klug, Günter; Unger, Annemarie; Fellinger, Matthäus; Süßenbacher, Stefanie; Freidl, Marion; Saumer, Gertraud; Wancata, Johannes

    2015-05-01

    Most studies about the burden of schizophrenia carers included only one care-giving relative, usually the patients' mothers. The present study intended to analyse differences of the level of burden between mothers and fathers of the same patients. 101 mothers and 101 fathers of the same patients suffering from schizophrenia were included into this study. They were assessed by means of the "Involvement Evaluation Questionnaire" and the "Carers' Needs Assessment for Schizophrenia". Mothers showed significantly higher scores than fathers regarding the subscores "Tensions" and "Urging". Multiple linear regression analyses showed positive associations between the frequency of mothers' as well as fathers' unmet needs and dimensions of caregiver involvement. Unmet needs among mothers and fathers have negative effects on their burden. The differences between mothers and fathers indicate the importance of considering the carer's gender in clinical work. © Georg Thieme Verlag KG Stuttgart · New York.

  1. THE EFFECTIVENESS OF COMBINATION OF KANGAROO MOTHER CARE METHOD AND LULLABY MUSIC THERAPY ON VITAL SIGN CHANGE IN INFANTS WITH LOW BIRTH WEIGHT

    Directory of Open Access Journals (Sweden)

    Nuuva Yusuf

    2017-08-01

    Full Text Available Background: Kangaroo mother care (KMC and lullaby music methods have been considered as the alternative treatment for vital sign changes in low birth weight infants. However, little is known about the combination of the two methods. Objective: To identify effectiveness of combinations of Kangaroo mother care and Lullaby music methods on changes in vital signs in low birth weight infants. Methods: A quasi experiment with non-equivalent control group design. This study was conducted on October– December 2016 at the General Hospital of Ambarawa and General Hospital of Ungaran, Semarang. There were 36 samples selected using consecutive sampling divided into three groups, namely: 1 a group of LBW infants with the combination of KMC and lullaby music, 2 a LBW infant group with the lullaby music intervention, and 3 a control group given standard care in LBW infants by KMC method. Paired t-test and MANOVA test were used to analyzed the data. Results: Findings revealed that there were significant differences between the combination group, lullaby music group, and control group in temperature (p=0.003, pulse (p=0.001, respiration (p=0.001, and oxygen saturation (p=0.014 with significant value of <0.05, which indicated that there was a statistically significant difference in vital sign changes among the three groups. Conclusion: The combination of KMC method and Lullaby music intervention was effective on vital sign changes (temperature, pulse, respiration, and oxygen saturation compared with the lullaby music group alone and control group with KMC method in low birth weight infants. It is suggested that the combination of KMC and Lullaby music methods can be used as an alternative to improve LBW care for mothers in the NICU and at home and to reach the stability of the baby's vital signs.

  2. Crisis Response Strategy and Crisis Types Suitability: A Preliminary Study on MH370

    Directory of Open Access Journals (Sweden)

    Mohamad Ashari Noratikah

    2017-01-01

    Full Text Available In time of crisis, the organisation’s tactic in responding to the crisis according to its type/s may significantly affect the organisation’s effort to survive its reputational damages. The study of crisis response strategy (CRS requires further exploration within the Malaysian context, moreso with the greater and apparent use of social media as a platform for the organisation in crisis to reach out to its stakeholders. This preliminary paper studies the MH370 crisis in light of Coombs [1] Situational Crisis Communication Theory (SCCT. It aims to discuss the suitability of the CRS applied by Malaysia Airlines System (MAS with the crisis type/s that was/were experienced by the organisation. Hence, the need for this paper to investigate the crisis type/s of MH370 and examines the CRS applied by MAS by content analysing media statements that were disseminated directly to the organisation’s stakeholders on Facebook during the first day of the crisis. Results ultimately show an interesting analysis to the crisis type of MH370, and the suitability of the CRS applied by MAS for that matter.

  3. a Comparison Between Chemically Dependent Mothers and Drug-Free Mothers: Lifestyle during the Perinatal Period

    Science.gov (United States)

    Uskokovic, Lila Milica

    This study compared maternal lifestyle variables pertinent to the perinatal period in groups of chemically dependent mothers and drug-free mothers. Twenty-nine cocaine -abusing mothers were compared to 29 drug-free mothers carefully matched on age, race, education, and primipara versus multipara status. The drug history of each chemically dependent woman was explicitly documented. The chemically dependent group was subdivided into two groups, mothers who abused cocaine and those who abused cocaine with concomitant opiate use. Each of these two subgroups was compared to its respective matched drug-free control group. Finally, a comparison was made between the two drug subgroups. All subjects were interviewed within 48 hours after delivery using the following measures: State-Trait Anxiety Inventory (A-State), Center for Epidemiologic Studies - Depression Scale, The Self-Esteem Scale, Maternal Adjustment and Maternal Attitude Questionnaire, The Neonatal Perception Inventory, The Psychiatric Epidemiology Research Interview Life Events Scale, Maternal Social Support Index, and Short Marital Adjustment Test. A t-test analysis revealed significant differences (p abused opiates with cocaine did not differ from their controls on depression and maternal adjustment and attitudes. No significant differences were obtained in the drug subgroup comparisons. These results identify increased life events and specific negative affect states that clinical intervention programs should address to assure the best possible outcome for chemically dependent mothers and their infants.

  4. A crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome.

    Science.gov (United States)

    Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T

    2012-07-01

    Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.

  5. The Effect of Mother Empowerment Program on Mothers’ Attachment to their Hospitalized Premature Neonates

    Directory of Open Access Journals (Sweden)

    Soheila Karbandi

    2015-06-01

    Full Text Available Background: Birth of a premature neonate is associated with hospital admission and separation from the family. Admission of the neonates intervenes on infant-mother attachment and so adversely affects on the quality of care given by the mother, and subsequently increases the risk of delayed behavioral problems in the children. Aim: To assess the effectiveness of mother empowerment program on the premature infant-mother attachment. Methods: In this randomized clinical trial, 70 mothers of premature infants, admitted to the neonatal intensive care unit (NICU of Omolbanin hospital of Mashhad in 2014, were divided into of intervention and control groups. The Empowerment program was a multi-step treatment program, in which information about the premature infants was provided to mothers through an illustrated booklet with a workbook and audio file in each step. Mothers in the control group received information and routine care according to the hospital guideline. The mother-infant attachment was measured after the intervention using the maternal and neonatal behaviors Avant tool. Data analysis was performed using chi-square and t-student tests by SPSS software version 11.5. Results:The mean scores of maternal attachment behaviors after the intervention in the empowerment and control groups were (56.62±8.06 and (39.51±7.77, respectively; the difference between the groups was statistically significant (P

  6. An Exploratory Study Examining Risk Communication among Adolescent Children, Their Incarcerated Mothers, and Their Caregivers.

    Science.gov (United States)

    Robillard, Alyssa G; Holliday, Rhonda C; DeHart, Dana D; Lewis, Kaleea; Rutherford, Yamisha; Amutah, Ndidi N

    2016-01-01

    Adolescent children of incarcerated mothers (ACIM) are typically left in the care of adults (primary caregivers) who play a crucial role in children's care and guidance, as well as in the facilitation of contact and communication with incarcerated mothers. The purpose of this study was to explore the nature of relationships and communication among adolescent children of incarcerated mothers, primary caregivers, and incarcerated mothers using pilot data. Semi-structured individual interviews were conducted with youth aged 12-17 (n=7) and caregivers (n=6) recruited through a non-profit organization working with incarcerated mothers and their children. Incarcerated mothers and primary caregivers represent an important family unit for ACIMs and may play a role in preventing risk behavior. A conceptual framework is offered for further consideration of mother and caregiver communication with youth and youth risk.

  7. Hemolytic crisis

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003270.htm Hemolytic crisis To use the sharing features on this page, please enable JavaScript. Hemolytic crisis occurs when large numbers of red blood cells ...

  8. The experience of mothers caring for their teenage daughters' young children

    Directory of Open Access Journals (Sweden)

    N Modungwa

    2000-09-01

    Full Text Available The purpose of this study was firstly to explore and describe the experiences of mothers who are looking after their teenage daughters’ young children. Secondly, to formulate guidelines (based on the results obtained for psychiatric nurses in assisting these mothers to mobilise resources in order to promote, maintain and restore their mental health as an integral part of health. An exploratory, descriptive, contextual and qualitative design was used and Guba’s model for ensuring trustworthiness in qualitative research was applied. The phenomenological approach was used to collect and analyse data from a sample of seven respondents who were purposively selected. Three independent themes emerged from the analysis of results: Meaning of the parenting role, life-style changes and support systems. The results further show that for these mothers the problem of teenage pregnancy and parenthood ends up being their problem. Their experiences in looking after these babies, although sometimes fulfilling and meaningful, are most of the time stressful. This has implications on their mental health. Guidelines are recommended in order to facilitate these mothers to mobilise their resources for mental health.

  9. MOTHERS PRACTICING PROSTITUTION AND CHILDREN'S RIGHTS

    OpenAIRE

    Ana-Maria MANDIUC

    2014-01-01

    A large number of women who practice prostitution get pregnant and have the child. When a mother continues practicing prostitution, while at the same time trying to fulfill parental responsibilities, the child’s rights could end up being violated because of the characteristics of the two roles the woman adopts. The present paper presents the case study of a child of schooling age and whose mother practiced prostitution. The child was put in foster care after the mother’s death and the case st...

  10. The impact of mothers' earnings on health inputs and infant health.

    Science.gov (United States)

    Mocan, Naci; Raschke, Christian; Unel, Bulent

    2015-12-01

    This paper investigates the impact of mothers' earnings on birth weight and gestational age of infants in the U.S. It also analyzes the impact of earnings on mothers' consumption of prenatal medical care, and their propensity to smoke and drink during pregnancy. The paper uses census division-year-specific skill-biased technology shocks as an instrument for mothers' earnings and employs a two-sample instrumental variables strategy. About 14 million records of births between 1989 and 2004 are used from the Natality Detail files along with the CPS Annual Demographic Files from the same period. The results reveal that an increase in weekly earnings prompts an increase in prenatal care of low-skill mothers (those who have at most a high school degree) who are not likely to be on Medicaid, and that earnings have a small positive impact on birth weight and gestational age of the newborns of these mothers. Specifically, if a mother's earnings double, this produces a weight gain of the newborn by about 100g and an increase in gestational age by 0.7 weeks. An increase in earnings does not influence the health of newborns of high-skill mothers (those with at least some college education). Variations in earnings have no impact on birth weight for mothers who are likely to be on Medicaid. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. the dutch crisis and recovery act: economic recovery and legal crisis

    African Journals Online (AJOL)

    Jonathan

    THE DUTCH CRISIS AND RECOVERY ACT: ECONOMIC RECOVERY AND. LEGAL CRISIS? J Verschuuren. 1 Introduction. Throughout the world, governments are responding to the financial and economic crisis. Such responses vary from supporting the banking system to adopting economic stimulus packages. The latter ...

  12. Mother-to-infant emotional involvement at birth.

    Science.gov (United States)

    Figueiredo, Bárbara; Costa, Raquel; Pacheco, Alexandra; Pais, Alvaro

    2009-07-01

    To study mother-to-infant emotional involvement at birth, namely factors (socio-demographics, previous life events, type of delivery, pain at childbirth, support from partner, infant characteristics, early experiences with the newborn, and mother's mood) that interfere with the mother's positive, negative and not clear emotions toward the newborn. The Bonding Scale (an extended Portuguese version of the 'New Mother-to-Infant Bonding Scale') and the Edinburgh Postnatal Depression Scale were administrated during the first after delivery days to 315 mothers recruited at Júlio Dinis Maternity Hospital (MJD, Porto, Portugal). A worse emotional involvement with the newborn was observed when the mother was unemployed, unmarried, had less than grade 9, previous obstetrical/psychological problems or was depressed, as well as when the infant was female, had neonatal problems or was admitted in the intensive care unit. Lower total bonding results were significantly predicted when the mother was depressed and had a lower educational level; being depressed, unemployed and single predicted more negative emotions toward the infant as well. No significant differences in the mother-to-infant emotional involvement were obtained for events related to childbirth, such as type of delivery, pain and partner support, or early experiences with the newborn; these events do not predict mother's bonding results either. The study results support the need for screening and supporting depressed, unemployed and single mothers, in order to prevent bonding difficulties with the newborn at birth.

  13. Dalla crisi finanziaria alla crisi reale. ( Financial and real crisis

    Directory of Open Access Journals (Sweden)

    Carlo D'Adda

    2010-03-01

    Full Text Available  The financial crisis of 2008 is put in relation with two bubbles, financial and housing. Easy credit is at the origin of both bubbles. Risky bonds were issued to mobilize mortgages originated in the housing market, and bad bonds entered a fantastic number of institutional and private portfolios all over the world without any perception of the their risk. Unfortunately, bank credit to speculators was abundant and fed the final growth of the bubbles. When fears started to spread, the fall was immediate and expectations impaired very rapidly. The main aggregate demand components were severely curtailed and production fell as well. This is the crisis of the real economy. Fortunately, as opposed to what happened in 1929, the interventions of central banks and governments have been of an unprecedented size. The bail out of insolvent banks in particular has been providential. The exit from the current crisis, however, will surely be slow.  JEL: E44, G01, G10

  14. Mother and offspring fitness in an insect with maternal care: phenotypic trade-offs between egg number, egg mass and egg care

    Science.gov (United States)

    2014-01-01

    Background Oviparous females have three main options to increase their reproductive success: investing into egg number, egg mass and/or egg care. Although allocating resources to either of these three components is known to shape offspring number and size, potential trade-offs among them may have key impacts on maternal and offspring fitness. Here, we tested the occurrence of phenotypic trade-offs between egg number, egg mass and maternal expenditure on egg care in the European earwig, Forficula auricularia, an insect with pre- and post-hatching forms of maternal care. In particular, we used a series of laboratory observations and experiments to investigate whether these three components non-additively influenced offspring weight and number at hatching, and whether they were associated with potential costs to females in terms of future reproduction. Results We found negative associations between egg number and mass as well as between egg number and maternal expenditure on egg care. However, these trade-offs could only be detected after statistically correcting for female weight at egg laying. Hatchling number was not determined by single or additive effects among the three life-history traits, but instead by pairwise interactions among them. In particular, offspring number was positively associated with the number of eggs only in clutches receiving high maternal care or consisting of heavy eggs, and negatively associated with mean egg mass in clutches receiving low care. In contrast, offspring weight was positively associated with egg mass only. Finally, maternal expenditure on egg care reduced their future reproduction, but this effect was only detected when mothers were experimentally isolated from their offspring at egg hatching. Conclusions Overall, our study reveals simultaneous trade-offs between the number, mass and care of eggs. It also demonstrates that these factors interact in their impact on offspring production, and that maternal expenditure on egg

  15. Effect of the economic crisis on the use of health and home care services among elderly Spanish diabetes patients.

    Science.gov (United States)

    Lopez-de-Andres, Ana; de Miguel-Diez, Javier; Hernandez-Barrera, Valentin; Jiménez-Trujillo, Isabel; Martinez-Huedo, Maria-Angeles; Del Barrio, José Luis; Jimenez-Garcia, Rodrigo

    2018-03-27

    To describe the utilization of health and home care services among older people (≥65 years) with diabetes during the economic crisis; to identify the factors associated with changes in the utilization of these services; and to study the time trends (2009-2014). We used the European Health Interview Surveys for Spain (EEHSS) for 2009/10 and 2014. The dependent variables included self-reported hospitalizations; general practitioner (GP) visits; 'other healthcare services' (OHS) used; and home care services (HCS) used. We identified 6026 and 6020 diabetic patients (EEHSS2009 and EEHSS2014, respectively). A significant decrease in the number of GP visits (OR 0.94; 95% CI 0.91-0.98) and the use of HCS (OR 0.95; 95% CI 0.91-0.99) was found; however, we found an increase in the use of OHS (OR 1.06; 95% CI 1.02-1.10). Multivariate models showed that factors associated with an increased use included chronic conditions, worse self-rated health, pain and mental disorders. Physical activity was a strong predictor of lower hospitalizations and HCS use. Female gender was associated with significantly lower hospitalizations and a higher use of OHC and HCS. We found a decrease in the number of GP visits and the use of HCS among elderly diabetic adults; however, we also observed an increase in the use of OHS, which may partly explain this decrease in the figures. Significant differences in the use of health services were found according to gender. The effect of the economic crisis, if any, seems to have had a small magnitude. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Breastfeeding considerations of opioid dependent mothers and infants.

    Science.gov (United States)

    Hilton, Tara C

    2012-01-01

    The American Academy of Pediatrics (AAP) has a long-standing recommendation against breastfeeding if the maternal methadone dose is above 20 mg/day. In 2001, the AAP lifted the dose restriction of maternal methadone allowing methadone-maintained mothers to breastfeed. The allowance of breastfeeding among mothers taking methadone has been met with opposition due to the uncertainty that exists related to methadone exposure of the suckling infant. Methadone-maintained mothers are at higher risk for abuse, concomitant psychiatric disorders, limited access to healthcare, and financial hardship. Breastfeeding rates among methadone-maintained women tend to be low compared to the national average. This manuscript will discuss the implications for healthcare practitioners caring for methadone-maintained mothers and infants and associated risks and benefits of breastfeeding. This population of mothers and infants stands to obtain particular benefits from the various well-known advantages of breastfeeding.

  17. Variations in depression care and outcomes among high-risk mothers from different racial/ethnic groups.

    Science.gov (United States)

    Huang, Hsiang; Chan, Ya-Fen; Katon, Wayne; Tabb, Karen; Sieu, Nida; Bauer, Amy M; Wasse, Jessica Knaster; Unützer, Jürgen

    2012-08-01

    PURPOSE. To examine variations in depression care and outcomes among high-risk pregnant and parenting women from different racial/ethnic groups served in community health centres. As part of a collaborative care programme that provides depression treatment in primary care clinics for high-risk mothers, 661 women with probable depression (Patient Health Questionnaire-9 ≥ 10), who self-reported race/ethnicity as Latina (n = 393), White (n = 126), Black (n = 75) or Asian (n = 67), were included in the study. Primary outcomes include quality of depression care and improvement in depression. A Cox proportional hazard model adjusting for sociodemographic and clinical characteristics was used to examine time to treatment response. We observed significant differences in both depression processes and outcomes across ethnic groups. After adjusting for other variables, Blacks were found to be significantly less likely to improve than Latinas [hazard ratio (HR): 0.53, 95% confidence interval (CI): 0.44-0.65]. Other factors significantly associated with depression improvement were pregnancy (HR: 1.52, 95% CI: 1.27-1.82), number of clinic visits (HR: 1.26, 95% CI: 1.17-1.36) and phone contacts (HR: 1.45, 95% CI: 1.32-1.60) by the care manager in the first month of treatment. After controlling for depression severity, having suicidal thoughts at baseline was significantly associated with a decreased likelihood of depression improvement (HR: 0.75, 95% CI: 0.67-0.83). In this racially and ethnically diverse sample of pregnant and parenting women treated for depression in primary care, the intensity of care management was positively associated with improved depression. There was also appreciable variation in depression outcomes between Latina and Black patients.

  18. Current Studies on Crisis Response Communication:Focus on Crisis Communication Theories in the United States

    OpenAIRE

    平澤 敦

    2017-01-01

    Researchers have shown an increased interest in crisis communication as well as crisis management. Crisis communication became an established corporate discipline in the last 20 years. Because of the recent rash of corporate (organizational) scandals, natural disasters and so on, importance of crisis communication (management) attracts much more attention than the past.Crisis communication is used to help governments and companies organizations to respond to and recover from a crisis. Crisis ...

  19. Barriers to uptake of prevention of mother-to-child transmission of HIV services among mothers of vertically infected HIV-seropositive infants in Makurdi, Nigeria

    Directory of Open Access Journals (Sweden)

    Anígilájé EA

    2016-01-01

    Full Text Available Emmanuel Ademola Anígilájé,1 Bem Ruben Ageda,2 Nnamdi Okechukwu Nweke1 1Department of Paediatrics, 2Department of Obstetrics and Gynaecology, Federal Medical Centre, Makurdi, Nigeria Background: Perinatal transmission of human immunodeficiency virus (HIV continues in Nigeria because of the poor use of prevention of mother-to-child transmission of HIV (PMTCT services. This study reports on the barriers preventing mothers of vertically infected HIV-seropositive infants to use the PMTCT services at the Federal Medical Centre, Makurdi, Nigeria.Methods: This is a descriptive study conducted between January and April, 2014. A quantitative survey was applied to detect barriers along the PMTCT services cascade among 52 mothers of vertically infected HIV-seropositive infants. This includes 22 women who attended antenatal care at the Federal Medical Centre (designated as Group A mothers and 30 women who did not receive any form of PMTCT service (Group B mothers. The study was supplemented with a focused group discussion involving 12 discussants from the two groups.Results: In the quantitative assessment: among the Group A mothers, falling asleep was the most common reason (n=22, 100% for missing therapeutic/prophylactic antiretroviral medicine; financial constraint (n=22, 100% was the most common reason for antenatal care visit defaults; and a lot of the mothers (n=11, 50.0% did not give nevirapine to their newborns because they delivered at home. Among Group B mothers, unawareness of HIV-seropositive status was the most common reason (n=28, 93.3% given for not accessing PMTCT services. In the qualitative study: noninvolvement of male partners, stigma and discrimination experienced by HIV-seropositive mothers, financial constraints in couples, involvement of traditional birth attendants in antenatal care and delivery of HIV-infected women, unawareness of HIV-seropositive status by pregnant women, poor health system, and the lack of funding for PMTCT

  20. Utilization of maternal healthcare among adolescent mothers in urban India: evidence from DLHS-3.

    Science.gov (United States)

    Singh, Aditya; Kumar, Abhishek; Pranjali, Pragya

    2014-01-01

    Background. Low use of maternal healthcare services is one of the reasons why maternal mortality is still considerably high among adolescents mothers in India. To increase the utilization of these services, it is necessary to identify factors that affect service utilization. To our knowledge, no national level study in India has yet examined the issue in the context urban adolescent mothers. The present study is an attempt to fill this gap. Data and Methods. Using information from the third wave of District Level Household Survey (2007-08), we have examined factors associated with the utilization of maternal healthcare services among urban Indian married adolescent women (aged 13-19 years) who have given live/still births during last three years preceding the survey. The three outcome variables included in the analyses are 'full antenatal care (ANC)', 'safe delivery' and 'postnatal care within 42 days of delivery'. We have used Chi-square test to determine the difference in proportion and the binary logistic regression to understand the net effect of predictor variables on the utilization of maternity care. Results. About 22.9% of mothers have received full ANC, 65.1% of mothers have had at least one postnatal check-up within 42 days of pregnancy. The proportion of mother having a safe delivery, i.e., assisted by skilled personnel, is about 70.5%. Findings indicate that there is considerable amount of variation in use of maternity care by educational attainment, household wealth, religion, parity and region of residence. Receiving full antenatal care is significantly associated with mother's education, religion, caste, household wealth, parity, exposure to healthcare messages and region of residence. Mother's education, full antenatal care, parity, household wealth, religion and region of residence are also statistically significant in case of safe delivery. The use of postnatal care is associated with household wealth, woman's education, full antenatal care, safe

  1. Impact of the global financial crisis on low birth weight in Portugal: a time-trend analysis.

    Science.gov (United States)

    Kana, Musa Abubakar; Correia, Sofia; Peleteiro, Barbara; Severo, Milton; Barros, Henrique

    2017-01-01

    The 2007-2008 global financial crisis had adverse consequences on population health of affected European countries. Few contemporary studies have studied its effect on perinatal indicators with long-lasting influence on adult health. Therefore, in this study, we investigated the impact of the 2007-2008 global financial crisis on low birth weight (LBW) in Portugal. Data on 2 045 155 singleton births of 1995-2014 were obtained from Statistics Portugal. Joinpoint regression analysis was performed to identify the years in which changes in LBW trends occurred, and to estimate the annual per cent changes (APC). LBW risk by time period expressed as prevalence ratios were computed using the Poisson regression. Contextual changes in sociodemographic and economic factors were provided by their trends. The joinpoint analysis identified 3 distinct periods (2 jointpoints) with different APC in LBW, corresponding to 1995-1999 (APC=4.4; 95% CI 3.2 to 5.6), 2000-2006 (APC=0.1; 95% CI -050 to 0.7) and 2007-2014 (APC=1.6; 95% CI 1.2 to 2.0). For non-Portuguese, it was, respectively, 1995-1999 (APC=1.4; 95% CI -3.9 to 7.0%), 2000-2007 (APC=-4.2; 95% CI -6.4 to -2.0) and 2008-2014 (APC=3.1; 95% CI 0.8 to 5.5). Compared with 1995-1999, all specific maternal characteristics had a 10-15% increase in LBW risk in 2000-2006 and a 20-25% increase in 2007-2014, except among migrants, for which LBW risk remained lower than in 1995-1999 but increased after the crisis. The increasing LBW risk coincides with a deceleration in gross domestic product growth rate, reduction in health expenditure, social protection allocation on family/children support and sickness. The 2007-2008 global financial crisis was associated with a significant increase in LBW, particularly among infants of non-Portuguese mothers. We recommend strengthening social policies aimed at maternity protection for vulnerable mothers and health system maintenance of social equity in perinatal healthcare.

  2. Differences in pain management between hematologists and hospitalists caring for patients with sickle cell disease hospitalized for vasoocclusive crisis.

    Science.gov (United States)

    Shah, Nirmish; Rollins, Margo; Landi, Daniel; Shah, Radhika; Bae, Jonathan; De Castro, Laura M

    2014-03-01

    Sickle cell disease (SCD) is a chronic disease characterized by multiple vaso-occlusive complications and is increasingly cared for by hospitalists. The purpose of this study is to examine differences in pain management between hematologists and hospitalists. We performed a single-institution, retrospective review of pain management patterns and outcomes in adult SCD patients hospitalized for vaso-occlusive crisis. Over 26 months, we found a total of 298 patients (120 cared for by the hematologists and 178 by hospitalists), with a mean age of 32 (range 19-58). Patients cared for by hospitalists had a lower total number of hours on a patient controlled analgesia (PCA) device (171 vs. 212 hours, P=0.11). Hospitalists also were significantly more likely to utilize demand only PCA (42% vs. 23%, P=0.002) and had a significantly lower rate of using both continuous and demand PCA (54% vs. 67%, P=0.04). In addition, patients cared for by hospitalists had a significantly shorter hospitalization (8.4 days) compared to hematologists (10 days, P=0.04) with a non-significant difference in 7 and 30 day readmission rates (7.2% vs. 6.7% and 40% vs. 35% respectively). We found patients cared for by hospitalists more frequently utilized home oral pain medication during admission, had shorter lengths of hospitalization, and did not have a significant increase in readmission rates.

  3. Crisis communication: an inequalities perspective on the 2010 Boston water crisis.

    Science.gov (United States)

    Galarce, Ezequiel M; Viswanath, K

    2012-12-01

    Although the field of crisis risk communication has generated substantial research, the interaction between social determinants, communication processes, and behavioral compliance has been less well studied. With the goal of better understanding these interactions, this report examines how social determinants influenced communications and behavioral compliance during the 2010 Boston, Massachusetts, water crisis. An online survey was conducted to assess Boston residents' knowledge, beliefs, attitudes, mass and interpersonal communication, and preventive behaviors on emergency preparedness topics dealing with the water crisis. Of a total sample of 726 respondents, approximately one-third (n = 267) reported having been affected by the water crisis. Only data from affected participants were analyzed. Following an order to boil water, 87.5% of respondents refrained from drinking unboiled tap water. These behaviors and other cognitive and attitudinal factors, however, were not uniform across population subgroups. All communication and behavioral compliance variables varied across sociodemographic factors. Crisis communication, in conjunction with other public health preparedness fields, is central to reducing the negative impact of sudden hazards. Emergency scenarios such as the Boston water crisis serve as unique opportunities to understand how effectively crisis messages are conveyed to and received by different segments of the population.

  4. Bridging the gaps: An early integrated support collaborative for at risk mothers in rural Maine.

    Science.gov (United States)

    Morton, Jennifer; Withers, Marjorie; Konrad, Shelley Cohen; Buterbaugh, Carry; Spence, RuthAnne

    2015-01-01

    The antecedents that contribute to health disparities in maternal child health populations begin before birth and extend into the early prenatal and gestational growth periods. Mothers and infants living in rural poverty in particular are at considerable risk for problems associated with reproductive health, including pregnancy complications and premature births. The aim of this manuscript is thus two-fold, to describe the epidemiologic makeup of the community and the intervention model of the Community Caring Collaborative. Innovative models of early-integrated care for high-risk mothers and children are showing promise for long-term outcomes. They foster environments that enable mothers to trust health systems while maintaining a workforce of high functioning health workers who understand the mechanisms that underpin maternal and child health disparities. The Community Caring Collaborative in Washington County, Maine developed one such model that has made inroads in bridging such gaps. This manuscript explicates a case study of how the Community Caring Collaborative came into being and why it established the Bridging model of comprehensive care. The focus of this manuscript is thus two-fold, the community and the intervention model. The "bridging model" develops trust-based relationships between high-risk mothers with the health system and its multiple resources. Community members with advanced training provide the support and care linkages that are critical for family success. Innovative models of collaborative care impact the health of vulnerable mothers and their children working toward a marked decrease in health related disparities.

  5. Talking about a Crisis - Italian Bloggers' Perceptions of Alitalia's Crisis Responses

    DEFF Research Database (Denmark)

    Valentini, Chiara; Romenti, Stefania

    In this study we intend to examine the way in which bloggers and blog readers framed a company performance during a crisis, but looking at the most discussed crisis's themes, at the sources of their statements and at their evaluations. To facilitate that, we focused on a specific crisis case......, the Alitalia's one, as this case shows some specificities that have influenced the contents of the communicative discourses among bloggers and blog readers on the organization's response to its crisis....

  6. Emergency care in case of acute psychotic and/or manic symptoms: Lived experiences of patients and their families with the first interventions of a mobile crisis team. A phenomenological study.

    Science.gov (United States)

    Daggenvoorde, Thea H; Gijsman, Harm J; Goossens, Peter J J

    2017-09-27

    To explore the lived experiences of patients with a psychotic or bipolar disorder and their families with emergency care during the first contact with a mobile crisis team. Open individual interviews were held with ten patients and ten family members. Content data-analysis was conducted. Communication and cooperation was difficult in several cases. Personal crisis plans were not always used. Stigma was felt, especially when police-assistance was needed. A calm, understanding attitude was appreciated. Focus explicitly on communication with the patient, despite the acute condition, enhances the chance of cooperation. Taking time for contact is important. © 2017 Wiley Periodicals, Inc.

  7. Hypertensive Crisis

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Hypertensive Crisis: When You Should Call 9-1-1 for ... Nov 13,2017 A hypertensive ( high blood pressure ) crisis is when blood pressure rises quickly and severely ...

  8. Between crisis, agency and return: the vulnerability of Bolivian migrants in Italy

    Directory of Open Access Journals (Sweden)

    Isabel Yépez del Castillo

    2014-09-01

    Full Text Available This article addresses the interrelationships between the economic crisis, international migration and the labour market, and their impact on female migration agency, both in the decision to migrate and in the subsequent possibility of return to Bolivia. Based on information collected in a large survey conducted in the city of Cochabamba and the tracing of multiple female migration trajectories, the extreme vulnerability of these women, who are the heads of single-parent households, working in elderly care in Bergamo, is shown. Despite their deteriorating working conditions in the context of current Italian economic crisis and the competition of immigrant care workers from countries of Eastern Europe, they choose to remain in Italy instead of returning to Bolivia.

  9. Neoliberalism, trade imbalances, and economic policy in the Eurozone crisis

    Directory of Open Access Journals (Sweden)

    Engelbert Stockhammer

    2016-12-01

    Full Text Available This paper analyzes the causes of the Eurozone crisis. In doing so, it carefully surveys authors from different economic schools of thought. The paper discusses competing explanations for European current account imbalances. Remarkably, opposing views on the relative importance of cost developments and demand developments in explaining current account imbalances can be found in both heterodox and orthodox economics. Regarding the assessment of fiscal and monetary policy there is a clearer polarisation, with heterodox analysis regarding austerity as unhelpful and most of orthodox economics endorsing it. We advocate a post-Keynesian view, which holds that current account imbalances are not a fundamental cause of the sovereign debt crisis. Rather, the economic policy architecture of the Eurozone, which aims at restricting the role of fiscal and monetary policy, is the key to understanding the crisis in Europe.

  10. Do Mothers Want Professional Carers to Love Their Babies?

    Science.gov (United States)

    Page, Jools

    2011-01-01

    This article reports an aspect of a life historical study which investigated the part that "love" played in mothers' decision-making about returning to work and placing their babies in day care. The article begins with a brief discussion of the context, including 21st-century policies in England to encourage mothers to return to the…

  11. Clinics in Mother and Child Health

    African Journals Online (AJOL)

    Clinics in Mother and Child Health is a bilingual journal and publishes (in ... Health Care Facility in South-South Nigeria: The Need for Middle Level Health Manpower ... Le syndrome des ovaires micropolykystiques chez les femmes infertiles à ...

  12. Death of a Child at Home or in Hospital: Experiences of Greek Mothers.

    Science.gov (United States)

    Papadatou, Danai; And Others

    1996-01-01

    Investigates experiences of Greek mothers who cared for a child dying of cancer. Highlighted some needs during the terminal period. Fifteen mothers were interviewed and both quantitative and qualitative procedures were used to analyze findings. Family networks played a significant role in supporting mother-child units, especially when death…

  13. Essential neonatal care utilization and associated factors among mothers in public health facilities of Aksum Town, North Ethiopia, 2016.

    Directory of Open Access Journals (Sweden)

    Megbey Berhe

    Full Text Available Globally, neonatal death accounts about 44% of child death in 2013. Ethiopia is one of the ten countries with the highest number of neonatal death. Worldwide, more than 43% of deaths among under five year children is contributed by neonates. Half of the neonatal death occur in the first day of life. Recommendations about newborn care practices may conflict with local beliefs and practices. So, it is important to understand the existing newborn care practice and factors affecting it in order to take interventions so as to decrease neonatal death.To assess magnitude of essential neonatal care utilization and associated factors among women visiting public health facilities in Aksum Town, Tigray, Northern Ethiopia, 2015.Facility based cross sectional study was conducted from December 30, 2015 to January 31, 2016.The sampled population are 423 women who gave live births within the last 6 months prior to data collection. Systematic random sampling technique was employed. Data were entered, coded and cleaned using Epi info version 7, and SPSS Version 21 software was used for analysis. Both bivariable and multivariable logistic regression models were used to determine factors associated with essential neonatal care utilization. Variables with P-value <0.2 in the bivariable logistic regression model were included in to multivariable logistic regression model, and finally variables with P-value <0.05 were considered as independent factors. Odds ratio was used to measure strength of association at 95% confidence level.A total of 423 mothers included in the study. Prevalence of safe cord care, optimal breast feeding, thermal care and baby received Tetracycline eye ointment and vaccine at birth were 42.8%, 63.1%, 32.6% and 44.7% among the respondents respectively. Only 113(26.7% of the participants fulfilled essential new born care practice. Occupation, parity and counseling on essential new born care during delivery were significantly associated with

  14. Timely referral saves the lives of mothers and newborns: Midwifery led continuum of care in marginalized teagarden communities - A qualitative case study in Bangladesh.

    Science.gov (United States)

    Biswas, Animesh; Anderson, Rondi; Doraiswamy, Sathyanarayanan; Abdullah, Abu Sayeed Md; Purno, Nabila; Rahman, Fazlur; Halim, Abdul

    2018-01-01

    Background: Prompt and efficient identification, referral of pregnancy related complications and emergencies are key factors to the reduction of maternal and newborn morbidity and mortality. As a response to this critical need, a midwifery led continuum of reproductive health care was introduced in five teagardens in the Sylhet division, Bangladesh during 2016. Within this intervention, professional midwives provided reproductive healthcare to pregnant teagarden women in the community.  This study evaluates the effect of the referral of pregnancy related complications. Methods: A qualitative case study design by reviewing records retrospectively was used to explore the effect of deploying midwives on referrals of pregnancy related complications from the selected teagardens to the referral health facilities in Moulvibazar district of the Sylhet division during 2016.  In depth analyses was also performed on 15 randomly selected cases to understand the facts behind the referral. Results: Out of a total population of 450 pregnant women identified by the midwives, 72 complicated mothers were referred from the five teagardens to the facilities. 76.4% of mothers were referred to conduct delivery at facilities, and 31.1% of them were referred with the complication of prolonged labour. Other major complications were pre-eclampsia (17.8%), retention of the placenta with post-partum hemorrhage (11.1%) and premature rupture of the membrane (8.9%). About 60% of complicated mothers were referred to the primary health care centre, and among them 14% of mothers were delivered by caesarean section. 94% deliveries resulted in livebirths and only 6% were stillbirths. Conclusions: This study reveals that early detection of pregnancy complications by skilled professionals and timely referral to a facility is beneficial in saving the majority of baby's as well as mother's lives in resource-poor teagardens with a considerable access barrier to health facilities.

  15. Collection for Refugee and Migration Crisis

    CERN Multimedia

    Rolf Heuer, Director-General,

    2015-01-01

    Dear Colleagues, In response to the current refugee and migration crisis, we are starting a collection today and we are calling on your generosity. The funds will be forwarded to the International Federation of Red Cross and Red Crescent Societies to respond to the humanitarian needs of the refugees and migrants, providing immediate and longer-term relief, including emergency medical care and basic health services, psychological support, temporary shelter, distribution of food & water and other urgently needed items. We hope that your contributions to the above-mentioned appeal will not prevent you from sparing a thought for them and doing whatever you can to help them. Bank account details for donations: Bank account holder: Association du personnel CERN - 1211 GENEVE 23 Account number: 279-HU106832.1 IBAN: CH85 0027 9279 HU10 6832 1 BIC:  UBSWCHZH80A Please mention: Refugee and Migration Crisis

  16. Relationship between low birth weight of babies and antenatal care of mothers: A cross sectional study at a tertiary care hospital of Kishanganj, Bihar

    Directory of Open Access Journals (Sweden)

    Malvika Dubey

    2015-01-01

    Full Text Available Background Low birth weight (LBW is important risk factor for childhood morbidity and mortality thus an important public health concern. Aim To identify the maternal determinants associated with LBW of babies Setting M.G.M Medical college & L.S.K Hospital Kishanganj ,Bihar. Design Hospital based cross sectional study Study period January 2014 to March 2014 Methodology Institution based descriptive cross sectional study from February 2014 to April 2014. All postnatal women (190 with singleton apparently healthy babies during the study period were selected for study. Birth weight of babies was recorded, mothers were interviewed and antenatal cards were reviewed. Result 34% of newborns were found to be low birth weight in our study. Statistically significant association was found between Low birth weight of babies and mother’s age, religion, literacy of mother, consumption of IFA tablets and regular ANC checkup during pregnancy. Conclusion The study suggests various maternal factors influence the birth weight of newborn babies and by improving antenatal care services both in coverage and quality we can reduce infant mortality in country.

  17. Visceral Crisis Means Short Survival Among Patients With Luminal A Metastatic Breast Cancer: A Retrospective Cohort Study.

    Science.gov (United States)

    Sbitti, Yassir; Slimani, Khaoula; Debbagh, Adil; Mokhlis, Anouar; Kadiri, Habiba; Laraqui, Abdelilah; Errihani, Hassan; Ichou, Mohamed

    2017-08-01

    Patients with visceral crisis from luminal metastatic breast cancer (mBC) are often treated with palliative chemotherapy. No studies have analyzed the aggressiveness of the care in visceral crisis from luminal mBC patients. The objective of this study was to assess practices in this setting in a university medical oncology department. This retrospective study included all patients who were managed for luminal mBC between January 2013 and April 2016. The analysis focused on the characteristics of the patients, the modalities of cancer treatment and delays between visceral crisis and death. Thirty-five patients pre-treated with two hormonal therapy lines were enrolled retrospectively. Worse performance status and a higher proportion of severe organ dysfunction for luminal mBC were observed among patients with visceral crisis. Sixty-five percent of patients received cytotoxic treatment. One cycle of chemotherapy was administrated in the majority of patients. Palliative care was performed in 35% of patients. Chemotherapy did not have any significant effect on patient outcome in the present study. The mean time between visceral crisis and death was 4.7 weeks (standard deviation = 1.9). Our study showed that visceral crisis in patients with luminal mBC is a complex problem. We need more comprehension of molecular pathogenesis to visceral crisis disease to propose efficacious treatments for these patients and to identify subgroup of patients who need chemotherapy followed by maintenance endocrine therapy.

  18. When Women with Cystic Fibrosis Become Mothers: Psychosocial Impact and Adjustments

    Directory of Open Access Journals (Sweden)

    Sophie L. Cammidge

    2016-01-01

    Full Text Available Advances in the treatment and life expectancy of cystic fibrosis (CF patients mean that motherhood is now a realistic option for many women with CF. This qualitative study explored the psychosocial impact and adjustments made when women with CF become mothers. Women with CF (n=11 were recruited via an online forum and participated in semistructured telephone interviews about their experiences of becoming a mother. Transcriptions were analysed using Grounded Theory. Analysis revealed three core categories: (i “Living with CF”: how becoming a mother impacted on health and treatment adherence, requiring a change in support from the CF team, (ii “Becoming a Mother”: balancing issues common to new mothers with their CF, and (iii “Pooling Personal Resources”: coping strategies in managing the dual demands of child and CF care. Participants experienced a variety of complex psychosocial processes. Most participants acknowledged an initial negative impact on CF care; however over time they reported successful adaptation to managing dual commitments and that adherence and motivation to stay well had improved. This study highlights the need for preconceptual psychosocial counselling and postpartum adjustment to CF care.

  19. Crisis Response Strategy and Crisis Types Suitability: A Preliminary Study on MH370

    OpenAIRE

    Mohamad Ashari Noratikah; Abang Ahmad Dayang Aizza Maisha; Samani Mus Chairil

    2017-01-01

    In time of crisis, the organisation’s tactic in responding to the crisis according to its type/s may significantly affect the organisation’s effort to survive its reputational damages. The study of crisis response strategy (CRS) requires further exploration within the Malaysian context, moreso with the greater and apparent use of social media as a platform for the organisation in crisis to reach out to its stakeholders. This preliminary paper studies the MH370 crisis in light of Coombs [1] Si...

  20. Leading in crisis: lessons for safety leaders.

    Science.gov (United States)

    George, William W; Denham, Charles R; Burgess, L Hayley; Angood, Peter B; Keohane, Carol

    2010-03-01

    The National Quality Forum (NQF) Safe Practices are a group of 34 evidence-based Safe Practices that should be universally used to reduce the risk of harm to patients. Four of these practices specifically address leadership. A recently published book, 7 Lessons for Leading in Crisis, offers practical advice on how to lead in crisis. An analysis of how concepts from the 7 lessons could be applied to the Safe Practices was presented nationally by webinar to assess the audience's reaction to the information. The objective of this article was to present the information and the audience's reaction to it. Recommendations for direct actions that health care leaders can take to accelerate adoption of NQF Safe Practices were presented to health care leaders, followed by an immediate direct survey that used Reichheld's "Net Promoter Score" to assess whether the concepts presented were considered applicable and valuable to the audience. In a separate presentation, the challenges and crises facing nursing leaders were addressed by nursing leaders. Six hundred seventy-four hospitals, with an average of 4.5 participants per hospital, participated in the webinar. A total of 272 safety leaders responded to a survey immediately after the webinar. A Net Promoter Score assessment revealed that 58% of those surveyed rated the value of the information at 10, and 91% scored the value of the webinar to be between 8 and 10, where 10 is considered a strong recommendation that those voting would recommend this program to others. The overwhelmingly high score indicated that the principles presented were important and valuable to this national audience of health care leadership. The 2010 environment of uncertainty and shrinking financial resources poses significant risk to patients and new challenges for leaders at all levels. A values-grounded focus on personal accountability for leading in crisis situations strongly resonates with those interested in or leading patient safety initiatives.

  1. Infant Care--Does Anybody Care?

    Science.gov (United States)

    Mills, Belen C.; And Others

    1988-01-01

    Discusses infant care in the United States by comparing U.S. practices of infant care to that in other industrialized nations. Suggests that in comparison to several other industrialized nations, the U.S. falls behind in providing support for mothers either to stay at home or to have quality alternative child care. (RJC)

  2. [Mothers of children with autistic disorder: perceptions and trajectories].

    Science.gov (United States)

    Ebert, Michele; Lorenzini, Elisiane; da Silva, Eveline Franco

    2015-03-01

    Childhood autism is characterized by severe and global impairment in several areas of human development and demands extensive care and dependence on the parents. The objective of this study was to understand the perceptions of mothers of children with autism regarding changes suffered by the child and their trajectories in search of an autism diagnosis. This is an exploratory descriptive study with a qualitative approach conducted with ten participant mothers. Data were collected in 2013 by means of semi-structured interviews. Thematic content analysis produced the following categories: perceptions of mothers as to changes in behaviour and/or development of their children; and trajectories of mothers in search of a diagnosis for their children. After the perception of changes in behaviour/development, mothers face an arduous trajectory of healthcare service utilization.

  3. The Euro crisis. Causes and Symptoms

    Directory of Open Access Journals (Sweden)

    Christoph S. Weber

    2015-06-01

    Full Text Available The Euro crisis is mainly a consequence of the international financial crisis of 2008. Thereby, the term Euro crisis is misleading as there is no currency crisis. First, the article shows some of the birth defects of the Euro. Second, it shows that the increase in public debt was caused by rescue measures for banks and anti-cyclical fiscal policy. Third, we argue that the Euro crisis is not just one crisis (a sovereign debt crisis but it is a combination of several macroeconomic crises including a growth crisis, a labour market crisis, a public debt crisis, and a current account crisis.

  4. Overpopulation crisis.

    Science.gov (United States)

    Russell, C; Russell Wms

    1984-01-01

    This article reviews field research on the violent response on the part of animals to conditions of crowding. Monkey species in zoos have consistently been noted to be more quarrelsome and violent than their counterparts in the wild. Up to a certain critical population density various animal species form cooperative social units; however, a surplus population upsets this balance. In addition, under conditions of intense crowding, mammal's care and protection of the young is transformed into indifference, neglect, competition, domination, and ultimately murder. The reversal of social behavior under crowded conditions can be understood as a means of response to a population crisis, in which population is in danger of outrunning resources. In the absence of confinement, tensions among monkeys lead to war between bands. A community weakened by crowding also is more likely to succumb to certain stress diseases and to have less resilience against parasites. Under various special conditions, tolerance may evolve to permit temporary compression without violence; on the other hand, when a violent response is suppressed, the response tends to be explosive when it does occur. If population reduction is delayed too long, the result may be violence, famine, and permanent damage to the environment from overgrazing. In human society there has generally been a lag in the full development of the violent response to crowding. Given the power of modern military technology, it is imperative that human populations avert a population crisis response by substituting voluntary fertility control for involuntary mortality control.

  5. The impact of crisis response strategy, crisis type, and corporate social responsibility on post-crisis consumer trust and purchase intention

    NARCIS (Netherlands)

    Hegner, Sabrina M.; Beldad, Ardion D.; Kraesgenberg, Anne Lotte

    2016-01-01

    Organisational crises can have deleterious consequences for organisational reputation and sales. Hence, one exigent question pertains to the effects of a company's action prior to the crisis and its crisis response on customers' post-crisis attitude and behavioural intention. To address that

  6. THE CURRENCY CRISIS TRIGGER OF THE ROMANIAN FINANCIAL CRISIS OF 2008

    Directory of Open Access Journals (Sweden)

    Radu SOVIANI

    2014-07-01

    Full Text Available This paper analyses the ways the financial crisis started to manifest into the Romanian Financial System, through the exchange rate channel. The focus of this Paper is on how the Romanian decision makers contributed in triggering the financial crisis (that would have been triggered anyway. The paper will determine the trigger (the first obvious event for the Romanian Financial Crisis (the debut and it will prove that the consequences of this trigger could have been anticipated - it is in line with similar triggers for the debut in other currency crises. Therefore, one of the main conclusions of this paper is that while a global crisis starts to manifest the local economy should limit the exuberance of the decision makers in order to smooth the effects of the crisis.

  7. Crisis Communication

    OpenAIRE

    Anca Jarmila Guţă

    2006-01-01

    The paper presents the manner in which the crisis of different types can disturb the normal activity of an organization and also the modalities by which the communication in this situation can solve or attenuate the negative effects of a crisis.

  8. Diabetic mothers and their newborn infants - rooming-in and neonatal morbidity

    DEFF Research Database (Denmark)

    Stage, E; Mathiesen, E R; Emmersen, P B

    2010-01-01

    As a result of increased neonatal morbidity, the infants of diabetic mothers have routinely been admitted to a neonatal special care unit (NSCU). We therefore investigated whether the offer of rooming-in diabetic mothers and their newborn infants has an effect on neonatal morbidity....

  9. Single Mothers in Russia : Household Strategies for Coping with Poverty

    OpenAIRE

    Lokshin, Michael; Harris, Kathleen Mullan; Popkin, Barry

    2000-01-01

    The authors describe trends in single parenthood in Russia, examining factors that affect living arrangements in single-mother families. Before economic reform, single mothers and their children were somewhat protected form poverty by government assistance (income support, subsidized child care, and full employment guarantees). Economic reform in Russia has reduced government transfers, el...

  10. Costo institucional de la crisis hipertensiva en el policlínico "Antonio Maceo" Institutional cost of hypertensive crisis in the "Antonio Maceo" polyclinic

    Directory of Open Access Journals (Sweden)

    Yosvany Tabares Silverio

    2011-06-01

    Full Text Available Introducción: la hipertensión arterial afecta la salud de las poblaciones en todas las partes del mundo. Representa por sí misma una enfermedad y también un factor de riesgo para otras afecciones cardiovasculares. Su impacto es en el área de la epidemiología, la salud pública, y en el aspecto económico. Objetivo: determinar el costo institucional de la atención al paciente con crisis hipertensiva en el servicio urgencia del policlínico "Antonio Maceo" de La Habana en el primer semestre del año 2008. Métodos: se realizó un estudio del tipo de descripción de costos. El enfoque metodológico utilizado fue el costo de la enfermedad, siguiendo los pasos recomendados en la Guía Metodológica para las Evaluaciones Económicas en Salud en Cuba. Los costos fueron expresados en pesos cubanos no convertibles del año 2008. La perspectiva de análisis adoptada fue la institucional. El universo de estudio estuvo constituido por 216 pacientes. En el cálculo del costo total institucional se consideraron las variables: costo por medicamentos, por medios diagnósticos, por salarios, entre otras. Resultados: se estudiaron 209 pacientes con urgencia hipertensiva (96,8 % y 7 con emergencia hipertensiva (3,2 %. El costo total de la atención del paciente con crisis hipertensiva ascendió a 5 451,68 pesos en moneda nacional y el costo promedio por paciente fue de 25,23. Conclusiones: el costo mayor en la atención al paciente con crisis hipertensiva estuvo relacionado con el salario directo. La adecuada dispensarización y tratamiento de los pacientes hipertensos pudiera disminuir el costo de la atención médica.Introduction: high blood pressure affects the health of populations at world scale. By itself represent a disease and a risk factor for other cardiovascular affections. Its impact is on the epidemiology, public health areas and in the economic feature. Objective: to determine the institutional cost of the patient care with hypertensive crisis

  11. A Study of Korean Working Mothers with Infants: Implications for Research and Social Policy

    Science.gov (United States)

    Seo, So-Jung

    2006-01-01

    The purpose of this study was to examine a broad range of variables that predict maternal self-efficacy with a sample of 92 Korean working mothers whose infants are cared for at non-maternal child care settings. In addition, differences between mothers of infants on welfare roll and their socioeconomic status (SES) counterparts (not on welfare)…

  12. Phthalate metabolites in Norwegian mothers and children: Levels, diurnal variation and use of personal care products.

    Science.gov (United States)

    Sakhi, Amrit Kaur; Sabaredzovic, Azemira; Cequier, Enrique; Thomsen, Cathrine

    2017-12-01

    Exposure to phthalates has been associated with reproductive and developmental toxicity. Data on levels of these compounds in the Norwegian population is limited. In this study, urine samples were collected from 48 mothers and their children in two counties in Norway. Eleven different phthalate metabolites originating from six commonly used phthalates in consumer products were determined. Concentrations of phthalate metabolites were significantly higher in children compared to mothers except for mono-ethyl phthalate (MEP). The mothers provided several urine samples during 24hours (h) and diurnal variation showed that the concentrations in the morning urine samples (24-8h) were significantly higher than at other time-periods for most of the phthalate metabolites. Intraclass correlation coefficients (ICCs) for 24-hour time-period were in the range of 0.49-0.81. These moderate to high ICCs indicate that one spot urine sample can be used to estimate the exposure to phthalates. Since a significant effect of time of day was observed, it is still advisable to standardize the collection time point to reduce the variation. For the mothers, the use of personal care products (PCPs) were less associated with morning urine samples than early day (8-12h) and evening (16-24h) urine samples. The use of perfume and hair products were positively associated with the urinary concentrations of low molecular weight phthalates. Use of shower soap and shampoo were positively associated with urinary concentration of di(2-ethylhexyl) phthalate (DEHP) metabolites. For children, face cream use was positively associated with phthalate metabolites in the morning samples, and hand soap use was negatively associated with concentration of urinary DEHP metabolites in afternoon/evening samples. Since different PCPs were associated with the urinary phthalate metabolites in different time-periods during a day, more than one spot urine sample might be required to study associations between urinary

  13. The social process of escalation: a promising focus for crisis management research

    Directory of Open Access Journals (Sweden)

    Bergström Johan

    2012-06-01

    Full Text Available Abstract Background This study identifies a promising, new focus for the crisis management research in the health care domain. After reviewing the literature on health care crisis management, there seems to be a knowledge-gap regarding organisational change and adaption, especially when health care situations goes from normal, to non-normal, to pathological and further into a state of emergency or crisis. Discussion Based on studies of escalating situations in obstetric care it is suggested that two theoretical perspectives (contingency theory and the idea of failure as a result of incomplete interaction tend to simplify the issue of escalation rather than attend to its complexities (including the various power relations among the stakeholders involved. However studying the process of escalation as inherently complex and social allows us to see the definition of a situation as normal or non-normal as an exercise of power in itself, rather than representing a putatively correct response to a particular emergency. Implications The concept of escalation, when treated this way, can help us further the analysis of clinical and institutional acts and competence. It can also turn our attention to some important elements in a class of social phenomenon, crises and emergencies, that so far have not received the attention they deserve. Focusing on organisational choreography, that interplay of potential factors such as power, professional identity, organisational accountability, and experience, is not only a promising focus for future naturalistic research but also for developing more pragmatic strategies that can enhance organisational coordination and response in complex events.

  14. Possibilities and tools of business crisis management during the natural crisis

    OpenAIRE

    Bosáková, Renáta

    2009-01-01

    This work analyses disposable tools of business crisis management to manage crisis which are induced by natural threats and it considers possibilities of these methods using. On basis of performed analysis then in the practical part it uses the acceptable methods and tools to look for threats and risks of the firm and suggests optimal structure of crisis plan.

  15. Effect of pregnancy during TMI crisis on mothers' mental health and their child's development

    International Nuclear Information System (INIS)

    Houts, P.S.; Tokuhata, G.K.; Bratz, J.; Bartholomew, M.J.; Sheffer, K.W.

    1991-01-01

    Five years after the Three Mile Island nuclear accident, the mental health of women who had been pregnant and living within 10 miles of Three Mile Island at the time of the accident was similar to that of women from the same area who became pregnant after the accident. Ratings of the development of the two groups of children when they were 5 years old were also similar. However, women who were pregnant during the crisis and had been extremely disturbed about their pregnancies rated their children's health as poorer than did the women who were pregnant later

  16. Activation of the maternal caregiving system by childhood fever – a qualitative study of the experiences made by mothers with a German or a Turkish background in the care of their children

    Science.gov (United States)

    2013-01-01

    Background Childhood fever represents a frequent cause to consult a primary care physician. “Fever phobia” describes a fearful and irrational view of fever shared by many parents with different cultural backgrounds. The study aims to explain the experiences of mothers of children having a fever and to analyze the role of the mothers’ cultural background with regard to their experiences by comparing the accounts of mothers with a German with those from a Turkish background. Disease and context specific knowledge about the influence of culture can be important for effective counselling. Methods We applied a qualitative approach using in-depth interviews with 11 mothers with a Turkish and 9 with a German background living in Germany. The interviews were conducted at the participants´ homes from May to October 2008. Data was audio-recorded and transcribed verbatim. Grounded Theory was used as a framing methodology including open, axial and selective coding. Analysis was performed in a group with members of different professional and cultural backgrounds. Results Mothers experienced their child’s fever not merely as elevated temperature but as a potentially dangerous event. A deeply rooted urge to protect the child from harm was central to all participants’ experience. The caregiving system model offers a good theoretical foundation to explain the findings as it incorporates the unique relational quality of care giving mothers to their children. The cultural background represents an important context variable influencing the explanatory models and strategies of dealing with fever. The identified culturally influenced concepts sometimes match and sometimes conflict with medical knowledge. Conclusion By applying the caregiving system model which is a part of attachment theory (Bowlby) maternal actions can be understood as an understandable attempt to protect the child from harm. The mothers´ decisions what to do when a child has a fever can be culturally

  17. Informed, advance refusals of treatment by people with severe mental illness in a randomised controlled trial of joint crisis plans: demand, content and correlates.

    Science.gov (United States)

    Henderson, Claire; Farrelly, Simone; Flach, Clare; Borschmann, Rohan; Birchwood, Max; Thornicroft, Graham; Waheed, Waquas; Szmukler, George

    2017-11-24

    In the UK, crisis planning for mental health care should acknowledge the right to make an informed advance treatment refusal under the Mental Capacity Act 2005. Our aims were to estimate the demand for such treatment refusals within a sample of service users who had had a recent hospital admission for psychosis or bipolar disorder, and to examine the relationship between refusals, and service user characteristics. To identify refusals we conducted content analysis of Joint Crisis Plans, which are plans formulated by service users and their clinical team with involvement from an external facilitator, and routine care plans in sub-samples from a multi-centre randomised controlled trial of Joint Crisis Plans (plus routine mental health care) versus routine care alone (CRIMSON) in England. Factors hypothesised to be associated with refusals were identified using the trial data collected through baseline interviews of service users and clinicians and collection of routine clinical data. Ninety-nine of 221 (45%) of the Joint Crisis Plans contained a treatment refusal compared to 10 of 424 (2.4%) baseline routine care plans. No Joint Crisis Plans recorded disagreement with refusals on the part of clinicians. Among those with completed Joint Crisis Plans, adjusted analyses indicated a significant association between treatment refusals and perceived coercion at baseline (odds ratio = 1.21, 95% CI 1.02-1.43), but not with baseline working alliance or a past history of involuntary admission. We demonstrated significant demand for written treatment refusals in line with the Mental Capacity Act 2005, which had not previously been elicited by the process of treatment planning. Future treatment/crisis plans should incorporate the opportunity for service users to record a treatment refusal during the drafting of such plans. ISRCTN11501328 Registered 13th March 2008.

  18. Communication in the state of crisis

    OpenAIRE

    Senić Vladimir; Senić Radoslav

    2015-01-01

    Due to diversity of research related to crisis it is rather important to present definitions of various key terms related to crisis, crisis management and crisis communication, in order to establish tangible boundaries among them. Those three are mutually intertwined and should be considered starting from the first symptoms of crisis to crisis management and finally crisis communication. In the state of crisis, conventional management practice is often not adequate, while types of reaction ar...

  19. Utilization of oral health services by mothers of preschool children in ...

    African Journals Online (AJOL)

    Objective: To determine oral health services utilization by mothers of pre school children in Jos North Local Government Area, Plateau State, Nigeria Design: Cross-sectional study. Setting: Four Primary Health Care (PHC) Clinics in Jos North Local Government Area Participants: 200 mothers of pre school children

  20. A Survey of the Opinions of Mothers, Proprietors and Caregivers on ...

    African Journals Online (AJOL)

    This study investigated the opinions of working mothers, proprietors and caregivers on services provided by day care centres in Ibadan. Sample consists of Two hundred and ninety-five respondents (220 working mothers, 50 Caregivers, and 25 Proprietors). They were randomly selected from the various government ...

  1. Dalla crisi finanziaria alla crisi reale

    Directory of Open Access Journals (Sweden)

    CARLO D’ADDA

    2010-01-01

    Full Text Available The financial crisis of 2008 is put in relation with two bubbles, financial and housing. Easy credit is at the origin of both bubbles. Risky bonds were issued to mobilize mortgages originated in the housing market, and bad bonds entered a fantastic number of institutional and private portfolios all over the world without any perception of the their risk. Unfortunately, bank credit to speculators was abundant and fed the final growth of the bubbles. When fears started to spread, the fall was immediate and expectations impaired very rapidly. The main aggregate demand components were severely curtailed and production fell as well. This is the crisis of the real economy. Fortunately, as opposed to what happened in 1929, the interventions of central banks and governments have been of an unprecedented size. The bail out of insolvent banks in particular has been providential. The exit from the current crisis, however, will surely be slow.

  2. The effectiveness of cognitive-function stress management training in glycemic control in children and in mental health of mother caring for child with type 1 diabetes mellitus.

    Science.gov (United States)

    Saghaei, Mozhdeh; Omidi, Pouya; Dehkordi, Elham Hashemi; Safavi, Parvin

    2017-12-01

    The study was aimed to evaluate the effectiveness of a training course of cognitive-behavioral stress management in glycaemia regulation in children with type 1 diabetes mellitus as well as in mental health status of their mothers. Fifty children with type 1 diabetes mellitus and their mothers were selected and randomly assigned into two groups. A group of mothers (n=25; as experimental one besides their children) passed a course, eight 2-h sessions, on the cognitive-behavioral and stress management, and the control group received the usual care. To evaluate the effectiveness of the intervention, before and after holding the course, glycosylated hemoglobin (HbA1C) test was done on both groups of children, and also some information was collected from the mothers through interview and the DASS (depression, anxiety, stress scale) and PSI (parenting stress index) questionnaires. After the intervention, HbA1c level decreased in the experimental group. Feeling of depression, anxiety and stress was significantly lower than the control group. Furthermore, training for parenting stress management positively affected on the sense of demanding, reinforcement, and adaptability in child domain and also on attachment, competence, depression, relationship with spouse and family health in parent domain. The intervention program was significantly effective in reducing the amount of HbA1c in diabetic children, and also reduced the intensity of psychosocial problems such as depression, anxiety and stress in the mothers caring for children with type 1 diabetes. Copyright © 2017. Published by Elsevier Ltd.

  3. THE ROLE AND IMPORTANCE OF COMPANY CRISIS DIAGNOSIS IN ANTI-CRISIS MANAGEMENT

    OpenAIRE

    Klodane, Alona

    2016-01-01

    Nowadays, under a free market, crises at companies are a frequent phenomenon; however, anti-crisis management and related aspects are currently a little researched problem in Latvia. The research aim is to examine the nature of company crisis diagnosis and its role and importance in the anti-crisis management system. The research general tasks are: to describe the nature of company crisis diagnosis and review the scope, purpose and tasks of performing a diagnosis; to examine the role and impo...

  4. Kangaroo mother care in resource-limited settings: implementation, health benefits, and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Uwaezuoke SN

    2017-06-01

    Full Text Available Samuel N Uwaezuoke Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku–Ozalla, Enugu, Nigeria Abstract: Kangaroo mother care (KMC represents an intervention in low birth weight infants for resource-limited settings which aims to reduce mortality rates by thermoregulation, supporting breastfeeding, and promoting early hospital discharge. In terms of cost and impact on neonatal survival, it has comparative advantages over the conventional method of care (CMC. This paper aimed to review the evidence concerning the progress of KMC implementation, its health benefits, and its cost-effectiveness, especially in developing countries. From the synthesized evidence, KMC was shown to be a useful adjunct to CMC particularly with respect to improving neonatal survival, supporting breastfeeding, and promoting early discharge from the hospital. Substantial progress has been made in its implementation in many developing countries where facility-based KMC has been institutionalized. Despite the cost-effectiveness of KMC in neonatal care, its global implementation is bedeviled with country-specific, multifaceted challenges. In developed countries, there is an implementation gap due to easy accessibility to technology-based CMC. Nevertheless, many developing countries have initiated national policies to scale up KMC services in their domain. Given the major constraints to program implementation peculiar to these resource-limited countries, it has become imperative to boost caregiver confidence and experience using dedicated spaces in the hospital, as well as dedicated staff meant for adequate ambulatory follow-up and continuous health education. Capacity training for health professionals and provision of space infrastructure thus constitute the basic needs which could be funded by International Aid Agencies in order to scale up the program in these settings. Keywords: neonatal care, low birth weight infants, thermoregulation, breastfeeding

  5. Breastfeeding policies and breastfeeding support programs in the mother's workplace.

    Science.gov (United States)

    Bettinelli, Maria Enrica

    2012-10-01

    Women should never be forced to make a choice between mother-work and other work. Many women mistakenly think they cannot breastfeed if they plan to return to work, and thus they may not talk with their employers about their intention to breastfeed or how breastfeeding might be supported at their workplace. All breastfeeding policies and strategies underline the importance of providing support for lactating mothers and highlight the need to promote specific interventions in the workplace. Possible strategies for working mothers include having the mother keep the baby with her while she works, allowing the mother to go to the baby to breastfeed during the workday, telecommuting, offering flexible work schedules, maintaining part-time work schedules, and using on-site or nearby child care centres.

  6. Hypercalcemic crisis resulting from near drowning in an indoor public bath.

    Science.gov (United States)

    Matsumoto, Ryusaku; Yamada, Go; Amano, Aya; Yamada, Tomoko; Hamamatsu, Keita; Murabe, Hiroyuki; Yokota, Toshihiko

    2013-01-01

    Male, 66. Hypercalcemic crisis. Near drowning state. - - Critical care medicine. Challenging differential diagnosis. Hypercalcemic crisis, generally caused by malignancy or primary hyperparathyroidism, is a life-threatening emergency that can result in multi-organ failure. Lowering the patient's calcium level immediately and determining the correct etiology are essential. We report a case of hypercalcemic crisis with a novel etiology. A 66-year-old male presented to the emergency room in cardiac arrest with a ventricular arrhythmia after being discovered submerged in an indoor public bath. He underwent cardioversion and was emergently intubated. Computed tomography showed bilateral pulmonary edema, suspected from water aspiration. Laboratory data revealed severe hypercalcemia and mild hypernatremia. Following three days of continuous hemodiafiltration, serum Ca decreased to and remained within normal limits. We concluded the etiology of hypercalcemia was absorption of Ca resulting from aspirated water. Near drowning can be a cause of hypercalcemic crisis. For cases of near drowning, it is important to investigate the source of the aspirated water and consider electrolyte abnormalities in the diagnosis.

  7. Crisis Diagnosis in Anti-Crisis Management Process in a Company

    OpenAIRE

    Ruta Meiste; Sandra Jakstiene

    2015-01-01

    Crisis concept links up to its appearance area. Some different kinds and levels of crises have been found: we face with global, mainly nature cataclysm crises, state economic crises, corporate crises and individual or psychological crises. The research area of this paper is micro level, i.e. corporate crises or crisis in a company. However, it is emphasized that company is a sociotechnical system, performing in a complex environment, therefore crisis in a company is closely related to global ...

  8. Narratives of crisis: identity crisis or crisis of meaning?!

    Directory of Open Access Journals (Sweden)

    Roseli Araújo Barros Costa

    2006-06-01

    Full Text Available This article is about a review of a broader research on the understanding of the professional development of Mathematics teachers, especially the results of the analysis of one of the selected categories, the projectors and the crisis narratives. This analysis was theoretically supported by Larrosa (2002. To carry out the research, we adopted the qualitative research, with a narrative focus, based on semi-structured interviews about the life history of a teacher who teaches mathematics in Basic Education. Based on a concept of professional development taken from a continuous perspective, idealized in a broader context of teaching work, permeating crises and conflicts, the analysis shows that the teacher's crisis reports are related to factors such as: low salaries, conflicts in her current institution Lack of social prestige and insecurity. His reports reveal that initial training did nothing to address the "new" changes in education. It shows that their lack of enthusiasm is associated with the emptying of the useful meaning of their formation, which results from the overvaluation of their exchange value. However, a crisis narrative can construct the present as a critical moment in the double sense of the word as a decisive moment and, at the same time, as a moment in which the subject critically recovers his own history, appropriates himself critically To find out where it is and to decide its own movement (LARRROSA, 2002. The individual, by critically restoring his history, can rethink the past, think the present, and (reconstruct his own future. The teacher, in her crisis narratives, shows that, by critically recovering her story, by putting out all her "revolt", she opens a "door" that will possibly show a new path to be taken. This seeks new challenges for their professional development

  9. The Critical Role of Crisis Communication Plan in Corporations’ Crises Preparedness and Management

    Directory of Open Access Journals (Sweden)

    Agnes Lucy Lando

    2014-06-01

    Full Text Available Many corporations have a Crisis Management Plan (CMP, which is designed to handle crises. These plans may include crisis response drills, evacuation plans, and standby machines/generators. However, when it comes to communication during a crisis, many organizations are ill-prepared because they lack a Crisis Communication Plan (CCP. Following the September 21, 2013 attack on the Westgate Mall in Nairobi, the public’s praises for the security forces swiftly degenerated into blame, insults, and expressions of betrayal. The government seemed unprepared. There was no clearly spelt out CCP detailing what and when to release information, as well as who and how to make the release. Hence, every step the government took to give updates about the attack and what it was doing to secure the mall and save people was challenged by the media and the public. The lack of a CCP was evident in the presentation of several spokespersons by the authorities, double talk, conflicting messages, and uncertainty on the matter. This paper thus argues that while corporations strive for a variety of strategies for crisis management, there is need to also enshrine CCP in their CMP. It utilizes Coombs’ (2012 three-stage crisis management model that carefully considers the pre-crisis, crisis, and post-crisis stages. Focusing on selected corporations in Kenya that suffered crises between June 1, 2012 and October 30, 2013, this research holds that the crises duration and negative impact could have been lessened if the organizations integrated effective CCP in their CMP.

  10. The true cost of the economic crisis on psychological well-being: a review

    Directory of Open Access Journals (Sweden)

    Van Hal G

    2015-01-01

    Full Text Available Guido Van Hal Medical Sociology and Health Policy, University of Antwerp, Antwerp, Belgium Abstract: The recent economic crisis has led to many negative consequences, not the least having to do with the mental health and well-being of the populations involved. Although some researchers say it is still too early to speak about a relationship between the economic crisis and a rise in mental health problems resulting in suicides, there is solid evidence for the existence of such a relationship. However, several moderating or mediating mechanisms can also play a role. The main reactions of most policy makers to the economic crisis are (severe austerity measures. These measures seem to have, however, a detrimental effect on the mental health of the population: Just when people have the highest need for mental help, cost-cutting measures in the health care sector lead to a (substantial drop in the supply of services for the prevention, early detection, and cure of mental health problems. Policy makers should support moderating mechanisms such as financial and psychological coping and acculturation and the role of primary health care workers in the early detection of suicidal thoughts, suicide attempts, and suicide in times of economic recession. Several examples show that the countries best off regarding the mental health of their populations during the economic crisis are those countries with the strongest social safety net. Therefore, instead of cutting back on health care and social welfare measures, policy makers should in the future invest even more in social protection measures during economic crises. Keywords: economic recession, mental health, suicide, social protection, austerity, review

  11. Political pragmatism and principles in times of crisis : the role of pragmatist political crisis management during the U.S. financial crisis

    NARCIS (Netherlands)

    Bartenberger, M.

    2017-01-01

    Based on philosophical pragmatism, this study builds a model of pragmatist crisis management at the political-strategic level and contrasts it with a principle-guided approach towards political crisis management. It identifies four cornerstons of pragmatist political crisis management and builds a

  12. Sickle Cell Crisis (For Teens)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Sickle Cell Crisis (Pain Crisis) KidsHealth / For Teens / Sickle Cell ... drepanocíticas (Crisis de dolor) What Is a Sickle Cell Crisis? Sickle cell disease changes the shape of ...

  13. Crisis Behavior in Autism Spectrum Disorders: A Self-Organized Criticality Approach

    Directory of Open Access Journals (Sweden)

    Lucio Tonello

    2018-01-01

    Full Text Available The Autism Spectrum Disorder (ASD represents a set of life-long disorders. In particular, subjects with ASD can display momentary behaviors of acute agitation and aggressiveness called crisis behaviors. These events are problematic for the subject and care providers but little is known about their occurrence, namely, possible relations among intensity, frequency, and duration. A group of ASD subjects (n=33 has been observed for 12 months reporting data on each crisis (n=1137 crises. Statistical analysis did not find significant results, while the relation between crisis duration and frequency showed a good fit to a “power law” curve, suggesting the application of Self-Organized Criticality (SOC model. The SOC is used to describe natural phenomena as earthquakes, bank failures of rivers, mass extinctions, and other systems where a type of “catastrophic events” is necessary to maintain a critical equilibrium. In a sense, subjects at risk of crisis behavior seem to fit the same model as seismic zones at risk of earthquakes. The employment of the same strategies, as those successfully developed for known SOC systems, could lead to important insights for ASD management. Moreover, the SOC model offers possible interpretations of crisis behavior dynamics suggesting that they are unpredictable and, in a sense, necessary.

  14. Companies’ management during economic crisis

    OpenAIRE

    Kumpikaitė, Vilmantė; Grybauskas, Andrius; Juodelis, Mantas; Strumyla, Dovydas

    2011-01-01

    Lots of companies faced recent economic crisis. It was generated by global markets deregulation and it triggered relevant situation to emerge other types of crisis. Many scientists all over the world analyses how crisis affected global economy and changed companies’ management actions. Scientists exclude these types of crisis: economic, informational, physical, human resource, reputational, psychopathic acts production and financial. This paper examines economic crisis generated negative effe...

  15. Maternal Perceptions and Views About Breastfeeding Practices Among Emirati Mothers.

    Science.gov (United States)

    Radwan, Hadia; Sapsford, Roger

    2016-03-01

    Understanding women's breastfeeding perceptions and experiences is increasingly recognized as a vital tool to provide effective support that would encourage the extension of the breastfeeding period. To identify and explore the perceptions and views that influence the feeding and weaning decisions of Emirati mother. A qualitative study using indepth interviews was undertaken with a convenience sample of 45 Emirati mothers who had infants aged between 6 months and 2 years. Participants were interviewed in the health centers in 3 cities in United Arab Emirates. Data were recorded through field notes and analyzed thematically using grounded theory analysis. The following themes emerged: influences of others on the decisions to breastfeed, sources of information, infants' behavior and participants' views and decisions about when to introduce supplementary feeding, knowledge of and attitudes toward current World Health Organization recommendations, and mothers' perception of the benefits of breastfeeding. Grandmothers in this study played an important role in the breastfeeding practices of Emirati mothers. They supported breastfeeding, however, some encouraged giving the infants prelacteal feeds for a variety of reasons: colic, hunger, promoting growth, and hydration. Fathers, according to the mothers, either supported or ignored breastfeeding practices. Health promotions and health care facilities failed to deliver the message of exclusive breastfeeding. Mothers in our study were resorting to the expertise of the grandmothers and receiving information and advice about child feeding from them. The findings highlight the need for successful intervention programs to be implemented for mothers and grandmothers through health care providers. © The Author(s) 2016.

  16. Energy crisis? The likelihood of a global energy crisis

    International Nuclear Information System (INIS)

    Franssen, H.

    2001-01-01

    This paper assess global energy problems and compares the energy crises of the 1970s with current US energy problems. The reaction of the OECD countries to the oil crises of 1973/4 and 1979/80, the perception of future oil supplies, and the difficulties faced by ordinary consumers in accepting that there is an energy crisis are discussed along with the Californian electricity crisis, the falling US natural gas supplies, and the low return on investment in the US refining industry. The prospect of another oil crisis, and the need for consumers to learn to live with price volatility are considered

  17. A focused ethnographic assessment of Middle Eastern mothers' infant feeding practices in Canada.

    Science.gov (United States)

    Jessri, Mahsa; Farmer, Anna P; Olson, Karin

    2015-10-01

    The aim of this study was to examine the barriers to following complementary feeding guidelines among Middle Eastern mothers and the cultural considerations of practitioners from an emic perspective. This is a two-phase focused ethnographic assessment of infant feeding among 22 Middle Eastern mothers in Western Canada who had healthy infants aged foods was whether or not foods were Halal, while food allergens were not causes for concern. Vitamin D supplements were not fed to 18/22 of infants, and mashed dates (Halawi), rice pudding (Muhallabia/Ferni) and sugared water/tea were the first complementary foods commonly consumed. Through constant comparison of qualitative data, three layers of influence emerged, which described mothers' process of infant feeding: socio-cultural, health care system and personal factors. Culture was an umbrella theme influencing all aspects of infant feeding decisions. Mothers cited health care professionals' lack of cultural considerations and lack of relevance and practicality of infant feeding guidelines as the main reasons for ignoring infant feeding recommendations. Early introduction of pre-lacteal feeds and inappropriate types of foods fed to infants among immigrant/refugee Middle Eastern mothers in Canada is cause of concern. Involving trained language interpreters in health teams and educating health care staff on cultural competency may potentially increase maternal trust in the health care system and eventually lead to increased awareness of and adherence to best practices with infant feeding recommendations. © 2013 John Wiley & Sons Ltd.

  18. Waiting for a Crisis: Case Studies of Crisis Leaders in Higher Education

    Science.gov (United States)

    Muffet-Willett, Stacy L.

    2010-01-01

    This study examines the system of crisis leadership in higher education. Using case study methods, five crisis leadership participants were interviewed to develop a deep understanding of how they perceive their university crisis leadership system. Two participants were from a private institution, and three were from a public institution. Higher…

  19. Interpersonal relationships between professionals and mothers of premature from Kangaroo-Unit

    Directory of Open Access Journals (Sweden)

    Francisca Eliene de Oliveira Callou

    2010-06-01

    Full Text Available Objective: To understand the interpersonal relationships between professionals and mothers of premature newborns of the Kangaroo Unit. Methods: This was an exploratory study of qualitative approach. The interviews were conducted with 10 mothers and 7 professionals who joined in Kangaroo Program and then analyzed by the content analysis technique. The guiding questions used were related to feelings perceived in relation to the Kangaroo method, related to mother-child dyad and interpersonal relationships. Results: Mothers reported on their speeches: “safe to be with the baby in Kangaroo Method” and “sense of maternal feeling during breastfeeding”, while in the professionals’ discourses have emerged: “guidelines on caring for the babies”, “the embracement by the team” and “the importance of family support.” Conclusions: The interaction between professionals and mothers of Kangaroo Unit facilitates the permanence of the binomial in the method, therefore develops feelings of security, tranquility and confidence to take care of the baby. It is important that the team be aware of the difficulties, supporting them in the weakest moments and sharing their fears, doubts and concerns over the baby’s hospitalization.

  20. Handling Kids in Crisis with Care

    Science.gov (United States)

    Bushinski, Cari

    2018-01-01

    The Handle with Care program helps schools help students who experience trauma. While at the scene of an event like a domestic violence call, drug raid, or car accident, law enforcement personnel determine the names and school of any children present. They notify that child's school to "handle ___ with care" the next day, and the school…

  1. Traditional Practices of Mothers in the Postpartum Period: Evidence from Turkey.

    Science.gov (United States)

    Altuntuğ, Kamile; Anık, Yeşim; Ege, Emel

    2018-03-01

    In various cultures, the postpartum period is a sensitive time and various traditional practices are applied to protect the health of the mother and the baby. The aim of this study was to determine traditional practices of mother care in the postpartum period in Konya City of Turkey. The research was a descriptive, cross-sectional study carried out among 291 women at the first 8 weeks of postpartum period who visited to family health centers from June 1 to December 1, 2015. The data were collected using questionnaires. Statistical analysis of the data was done with SSPS version 22.0. Descriptive statistics were used to analyze the data. Based on the results, 84.5% of women applied a traditional mother care practice during the postpartum period. The most popular, were practices for increasing of breast milk (97.9%), preventing incubus "albasması" (81.8%), getting rid of incubus (74.9%), and preventing postpartum bleeding (14.1%).The findings of the study show that traditional practices towards mother care in the period after birth are common. In order to provide better health services, it is important for health professionals to understand the traditional beliefs and practices of the individuals, families, and society that they serve.

  2. Values transferred and cherished by mothers in the rural families in the Polish Second Republic

    Directory of Open Access Journals (Sweden)

    ANNA JÓZEFOWICZ

    2017-10-01

    Full Text Available In the Polish Second Republic, so in the country rebom afiter one hundred twenty three years of captivity, the role of a woman as a woman-mother, was significantly emphasized. Press, literature, researchers have proved that safety and order in the whole country depend on safety and order in individual families. The key notion became: „from education of a mother to education of a child”. While analyzing sources such as newspapers, magazines, diaries, guidebooks, I noticed the following values for which mothers in rural families were held to be responsible: 1 ,value of work connected with obligation in farm and household, so role of mother asahousewife; 2.the value of the family as a community and the mother's role in it. Mother was the first protector, tutor, patron of a child. Mother took care of child and other members in the family, she helped them, she guaranteed the positive atmosphere at home, took care of safety in a wide context. It was significant that mother appealed in the process of socialization to common traditions and experiences; 3.value of education and social consciousness, so the role of the mother in shaping social consciousness; 4.patriotic value, so the role of the mother in shaping patriotic attitude

  3. Mothering From the Inside Out: Results of a second randomized clinical trial testing a mentalization-based intervention for mothers in addiction treatment.

    Science.gov (United States)

    Suchman, Nancy E; DeCoste, Cindy L; McMahon, Thomas J; Dalton, Rachel; Mayes, Linda C; Borelli, Jessica

    2017-05-01

    Mothers with histories of alcohol and drug addiction have shown greater difficulty parenting young children than mothers with no history of substance misuse. This study was the second randomized clinical trial testing the efficacy of Mothering From the Inside Out (MIO), a 12-week mentalization-based individual therapy designed to address psychological deficits commonly associated with chronic substance use that also interfere with the capacity to parent young children. Eighty-seven mothers caring for a child between 11 and 60 months of age were randomly assigned to receive 12 sessions of MIO versus 12 sessions of parent education (PE), a psychoeducation active control comparison. Maternal reflective functioning, representations of caregiving, mother-child interaction quality, and child attachment were evaluated at baseline and posttreatment and 3-month follow-up. Mother-child interaction quality was assessed again at 12-month follow-up. In comparison with PE mothers, MIO mothers demonstrated a higher capacity for reflective functioning and representational coherence at posttreatment and 3-month follow-up. At 12-month follow-up, compared to PE cohorts, MIO mothers demonstrated greater sensitivity, their children showed greater involvement, and MIO dyads showed greater reciprocity. As addiction severity increased, MIO also appeared to serve as a protective factor for maternal reflective functioning, quality of mother-child interactions, and child attachment status. Results demonstrate the promise of mentalization-based interventions provided concomitant with addiction treatment for mothers and their young children.

  4. Mothering from the Inside Out: Results of a second randomized clinical trial testing a mentalization-based intervention for mothers in addiction treatment

    Science.gov (United States)

    Suchman, Nancy E.; DeCoste, Cindy L.; McMahon, Thomas J.; Dalton, Rachel; Mayes, Linda C.; Borelli, Jessica

    2016-01-01

    Mothers with histories of alcohol and drug addiction have shown greater difficulty parenting young children than mothers with no history of substance misuse. This study was the second randomized clinical trial testing the efficacy of Mothering from the Inside Out (MIO), a 12-week mentalization-based individual therapy designed to address psychological deficits commonly associated with chronic substance use that also interfere with the capacity to parent young children. Eighty-seven mothers caring for a child between 11 and 60 months of age were randomly assigned to receive 12 sessions of MIO versus 12 sessions of Parent Education (PE)—a psychoeducation active control comparison. Maternal reflective functioning, representations of caregiving, mother-child interaction quality, and child attachment were evaluated at baseline and post-treatment and 3-month follow up. Mother-child interaction quality was assessed again at 12-month follow up. In comparison with PE mothers, MIO mothers demonstrated a higher capacity for reflective functioning and representational coherence at post-treatment and 3-month follow up. At 12-month follow up, compared to PE cohorts, MIO mothers demonstrated greater sensitivity, their children showed greater involvement, and MIO dyads showed greater reciprocity. As addiction severity increased, MIO also appeared to serve as a protective factor for maternal reflective functioning, quality of mother-child interactions, and child attachment status. Results demonstrate the promise of mentalization-based interventions provided concomitant with addiction treatment for mothers and their young children. PMID:28401850

  5. Research on Sichuan Cuisine Enterprises Crisis

    Directory of Open Access Journals (Sweden)

    Jianfei Nan

    2014-04-01

    Full Text Available It is impossible to avoid crisis for Sichuan cuisine enterprises. On the basis of emphasizing the importance of the research of Sichuan cuisine enterprises crisis, the paper mainly analyzed the issue of Sichuan cuisine enterprises crisis from three aspects including formation mechanism of Sichuan cuisine enterprises crisis, the impact mechanism of Sichuan cuisine enterprises crisis and its response measures(such as principles, methods and strategiesin order to provide an important reference so that Sichuan cuisine enterprises have a correct understanding of the crisis, effectively response to the crisis, and strengthen crisis management so as to achieve their scientific development themselves. To some extent, the paper is helpful to cope with the crisis and promote the safety operation of the enterprises which are facing the crisis.

  6. Juggling and struggling: a preliminary work-life study of mothers with adolescents who have developmental disabilities.

    Science.gov (United States)

    Parish, Susan L

    2006-12-01

    A focus group study was conducted to develop an understanding of the experiences of mothers who are trying to balance employment with caring for an adolescent with developmental disabilities. Mothers reported facing considerable difficulties balancing work and caregiving responsibilities because support services rapidly declined when their child reached adolescence. Service cuts were related to the fact that adolescents are expected to be able to care for themselves, despite the fact that for many adolescents with disabilities, this is not possible. The mothers also reported that the preponderance of the responsibility for arranging care for their children was theirs and was not shouldered by their partners. Policy implications are discussed.

  7. Telephone Crisis Support Workers' Intentions to Use Recommended Skills While Experiencing Functional Impairment.

    Science.gov (United States)

    Kitchingman, Taneile A; Wilson, Coralie J; Woodward, Alan; Caputi, Peter; Wilson, Ian

    2018-05-01

    Empathic engagement with distressed others can lead to elevated symptoms of psychological distress and functional impairment, which preclude helping professionals' delivery of optimal patient care. Whether telephone crisis support workers are impacted in a similar way is not currently reported in the literature. This study examined the relationship between functional impairment and intentions to use recommended support skills in a representative national sample of 210 telephone crisis support workers. Participants completed an online survey including measures of functional impairment and intentions to use recommended telephone crisis support skills with callers reporting suicidal ideation, symptoms of depression, and anxiety. As a group, participants who experienced greater functional impairment during the past month reported significantly lower intentions to use recommended support skills with callers than those who reported lower functional impairment. Future research is needed to clarify the extent to which results generalize to telephone crisis support workers from other organizations. Results warrant further research to (a) identify determinants of telephone crisis support workers' functional impairment, and (b) for the deliberate management of telephone crisis support workers' functional impairment through developing and/or modifying existing service strategies to optimize workers' psychological well-being and delivery of support to callers.

  8. Mothering: The View from Psychological Research.

    Science.gov (United States)

    Gerson, Mary-Joan; And Others

    1984-01-01

    Summarizes research on various aspects of mothering, including the decision to have children, child rearing in the early years and maternal employment, and late parenting with adult children. Urges an ecological perspective toward parenting and various publicly and privately-supported child care facilities and arrangements. (CJM)

  9. Consequences of the crisis: New concepts

    OpenAIRE

    Andrei Marga

    2010-01-01

    The crisis that started in 2008 began with the malfunctioning of the financial mechanisms, i.e. as a financial crisis; it quickly became an economic crisis and is now threatening to become an energetic crisis and, lately, a crisis of agricultural products, announcing at the same time the crisis of a development model and an ontological crisis. It engages the questioning of certain conceptualizations and orientations. If one wonders about the new concepts employed by the foreseen “ontological ...

  10. Depression treatment for impoverished mothers by point-of-care providers: A randomized controlled trial.

    Science.gov (United States)

    Segre, Lisa S; Brock, Rebecca L; O'Hara, Michael W

    2015-04-01

    Depression in low-income, ethnic-minority women of childbearing age is prevalent and compromises infant and child development. Yet numerous barriers prevent treatment delivery. Listening Visits (LV), an empirically supported intervention developed for delivery by British home-visiting nurses, could address this unmet mental health need. This randomized controlled trial (RCT) evaluated the effectiveness of LV delivered at a woman's usual point-of-care, including home visits or an ob-gyn office. Listening Visits were delivered to depressed pregnant women or mothers of young children by their point-of-care provider (e.g., home visitor or physician's assistant), all of whom had low levels of prior counseling experience. Three quarters of the study's participants were low-income. Of those who reported ethnicity, all identified themselves as minorities. Participants from 4 study sites (N = 66) were randomized in a 2:1 ratio, to LV or a wait-list control group (WLC). Assessments, conducted at baseline and 8 weeks, evaluated depression, quality of life, and treatment satisfaction. Depressive severity, depressive symptoms, and quality of life significantly improved among LV recipients as compared with women receiving standard social/health services. Women valued LV as evidenced by their high attendance rates and treatment satisfaction ratings. In a stepped model of depression care, LV can provide an accessible, acceptable, and effective first-line treatment option for at-risk women who otherwise are unlikely to receive treatment. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  11. Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital

    Directory of Open Access Journals (Sweden)

    Benaiges D

    2014-05-01

    Full Text Available D Benaiges,1–3 JJ Chillarón,1–3 MJ Carrera,1,3 F Cots,3,4 J Puig de Dou,1 E Corominas,1 J Pedro-Botet,1–3 JA Flores-Le Roux,1–3 C Claret,1 A Goday,1–3 JF Cano1–3 1Department of Endocrinology and Nutrition, Hospital del Mar, 2Department of Medicine, Universitat Autònoma de Barcelona, 3Institut Hospital del Mar d’Investigacions Mèdiques, 4Epidemiology and Evaluation Department, Parc de Salut Mar, Barcelona, Spain Background: The purpose of this prospective cohort study was to compare the costs of day hospital (DH care for hyperglycemic crisis in elderly diabetic patients with those of conventional hospitalization (CH. Secondary objectives were to compare these two clinical scenarios in terms of glycemic control, number of emergency and outpatient visits, readmissions, hypoglycemic episodes, and nosocomial morbidity. Methods: The study population comprised diabetic patients aged >74 years consecutively admitted to a tertiary teaching hospital in Spain for hyperglycemic crisis (sustained hyperglycemia [>300 mg/dL] for at least 3 days with or without ketosis. The patients were assigned to DH or CH care according to time of admission and were followed for 6 months after discharge. Exclusion criteria were ketoacidosis, hyperosmolar crisis, hemodynamic instability, severe intercurrent illness, social deprivation, or Katz index >D.Results: Sixty-four diabetic patients on DH care and 36 on CH care were included, with no differences in baseline characteristics. The average cost per patient was 1,345.1±793.6 € in the DH group and 2,212.4±982.5 € in the CH group (P<0.001. There were no differences in number of subjects with mild hypoglycemia during follow-up (45.3% DH versus 33.3% CH, P=0.24, nor in the percentage of patients achieving a glycated hemoglobin (HbA1c <8% (67.2% DH versus 58.3% CH, P=0.375. Readmissions for hyperglycemic crisis and pressure ulcer rates were significantly higher in the CH group

  12. Family Conflict and Resilience in Parenting Self-Efficacy Among High-Risk Mothers

    NARCIS (Netherlands)

    Cassé, Julie F.H.; Finkenauer, Catrin; Oosterman, Mirjam; van der Geest, Victor R.; Schuengel, Carlo

    2018-01-01

    Mothers with a history of institutional care in adolescence are often involved in high-conflict partner relationships, which may undermine relationships with children and confidence in oneself as a parent. Not all mothers think of themselves as bad parents under these circumstances. We turned to

  13. Caring for a Daughter with Intellectual Disabilities in Managing Menstruation: A Mother's Perspective

    Science.gov (United States)

    Chou, Yueh-Ching; Lu, Zxy-Yann Jane

    2012-01-01

    Background: The concerns of mothers and their experiences while providing help to their daughters with intellectual disability (ID) and considerable support needs during menstruation have rarely been addressed. This qualitative study explored mothers' experiences and perceptions of managing their daughters' menstruation. Method: Twelve Taiwanese…

  14. Mothers recovering from cocaine addiction: factors affecting parenting skills.

    Science.gov (United States)

    Coyer, S M

    2001-01-01

    To identify factors that may influence parenting by mothers who are recovering from cocaine addiction. Exploratory descriptive, with in-depth unstructured interviews. Interviews were conducted in the woman's home or in a treatment center. A convenience sample of 11 women recovering from cocaine addiction who were mothers of children 3 years of age and younger. A content analysis was used to analyze the interview data. Two themes, personal/psychologic factors and environmental/contextual factors, and four subthemes emerged. They identify issues that may affect parenting by mothers being treated for cocaine addiction. Subthemes included low self-esteem, difficulty developing a maternal identity, isolation from friends and family, and chronic life stress. This study provides a better understanding of the sources contributing to vulnerability in the parenting role for mothers recovering from cocaine addiction and will assist nurses in providing care for these mothers and their children.

  15. Health care and higher education governance

    DEFF Research Database (Denmark)

    Vrangbæk, Karsten; Arrevaara, Timo; Hansen, Hanne Foss

    2017-01-01

    reveals patterns and constraints in different institutional settings. The paper concludes that Denmark and Norway initially tried to shelter the health care and higher education sectors, but they have moved on to more radical strategic responses as the crisis has persisted. Many similarities in the crisis...

  16. Paternal involvement in pediatric Type 1 diabetes: fathers' and mothers' psychological functioning and disease management.

    Science.gov (United States)

    Hansen, Jennifer A; Weissbrod, Carol; Schwartz, David D; Taylor, W Patrick

    2012-03-01

    Psychological functioning in fathers of children with Type 1 diabetes has received relatively little attention compared to mothers. This study examined fathers' perceived involvement in their children's diabetes care as it related to mothers' and fathers' pediatric parenting stress, depression, anxiety, marital satisfaction, and sleep, and to their children's diabetes regimen adherence and glycemic control. Eighty-two mothers and 43 fathers completed questionnaires. Multivariate linear regressions were conducted separately for mothers and fathers to determine the relationships between the perceived amount and the perceived helpfulness of father involvement in child diabetes care on parental psychosocial functioning and child diabetes control. Maternal perceptions of father helpfulness and amount of involvement in illness care were related to improved marital satisfaction and fewer depressive symptoms in mothers. In fathers, perception of their own amount of involvement was related to increased pediatric parenting stress and anxiety. Better child regimen adherence was associated with maternal perceptions of father helpfulness but not the amount of their involvement, while paternal perceptions of their own helpfulness were related to poorer glycemic control. These findings suggest that fathers and mothers may react differently to their roles in childhood illness and that perceptions of their involvement may be differently associated with children's glycemic control and regimen adherence.

  17. Economic crisis: prelude to an energetic crisis?

    International Nuclear Information System (INIS)

    Chevallier, B.

    2009-01-01

    Recession due to the financial crisis of 2008 has stopped the world economic development and the hydrocarbons sector too. Collapse of prices, cancellation of investments, reach of a 'peak demand', the four speeches which are given here, describe these impacts and their consequences; but in scrutinizing the incentives of the crisis, they show the new role of petroleum: pretext value against the weakness of dollar and the inflation risks, speculative value for the investment funds. (O.M.)

  18. Talking to Parents: Communication in Times of Crisis and Beyond.

    Science.gov (United States)

    Wendell, Charlene

    2002-01-01

    Camps should always have a crisis management plan, but the events of September 11, 2001, make it especially important. Honest communication with parents is paramount--directors should choose their words carefully and control the tone of their voices. Examples are given of crises involving weather, transportation, and a shooting. Questions to…

  19. Needs Expressed by Mothers and Fathers of Young Children with Disabilities.

    Science.gov (United States)

    Bailey, Donald B., Jr.; And Others

    1992-01-01

    Expressed needs of mothers and fathers (n=422 parents) of young children with disabilities were compared and related to child and family characteristics. Mothers expressed more needs than did fathers, primarily in "Family and Social Support,""Explaining to Others," and "Child Care." Birth order, age, and race were not determinants of expressed…

  20. Cerebral palsy: experiences of mothers after learning their child's diagnosis.

    Science.gov (United States)

    Huang, Yu-Ping; Kellett, Ursula M; St John, Winsome

    2010-06-01

    This study is a report of a study describing mothers' experience of learning that their child has been diagnosed with cerebral palsy. Learning a child's diagnosis of disability is a crisis for parents. Their reactions include shock, refusal to accept the diagnosis, anger, fear, and uncertainty about the extent of disability and associated impairment. Knowledge about parental reactions is based on studies conducted in western countries, many of which do not apply to Taiwan where Confucianism strongly influences cultural perspectives of family and disability. In this phenomenological study, data were collected in 2005-2006 using in-depth interviews and journaling with 15 Taiwanese mothers of children diagnosed with cerebral palsy. Hermeneutic analysis was undertaken of interview transcripts and journal notes. Four shared meanings associated with learning of their child's diagnosis were revealed: feeling out of control and powerless, mistrusting healthcare professionals, release and confirmation, and feeling blamed for not following traditional practices. Mothers experienced a loss of their 'ideal' child when their child was diagnosed with cerebral palsy. Expectations of 'normal' motherhood and fulfilling societal anticipation of giving birth to a healthy child were lost. Maintaining their husband's family honour and prosperity, as well as saving face in their community were threatened. Mixed feelings of disbelief, rejection, self-blame and sadness were compounded by uncertainty about their child's future. To promote better understanding of the child's condition, emotional support and information should be provided to the mother and family, both when informing them of the diagnosis and in the period after diagnosis.